ABSTRACT
BACKGROUND: Nonoperative treatment of traumatic shoulder dislocations leads to a high rate of recurrent dislocations. HYPOTHESIS: Early arthroscopic treatment for shoulder dislocation will result in a lower recurrence rate than nonoperative treatment. STUDY DESIGN: Prospective, randomized clinical trial. METHODS: Two groups of patients were studied to compare nonoperative treatment with arthroscopic Bankart repair for acute, traumatic shoulder dislocations in young athletes. Fourteen nonoperatively treated patients underwent 4 weeks of immobilization followed by a supervised rehabilitation program. Ten operatively treated patients underwent arthroscopic Bankart repair with a bioabsorbable tack followed by the same rehabilitation protocol as the nonoperatively treated patients. The average follow-up was 36 months. RESULTS: Three patients were lost to follow-up. Twelve nonoperatively treated patients remained for follow-up. Nine of these (75%) developed recurrent instability. Six of the nine have required subsequent open Bankart repair for recurrent instability. Of the nine operatively treated patients available for follow-up, only one (11.1%) developed recurrent instability. CONCLUSIONS: Arthroscopic stabilization of traumatic, first-time anterior shoulder dislocations is an effective and safe treatment that significantly reduces the recurrence rate of shoulder dislocations in young athletes when compared with conventional, nonoperative treatment.
Subject(s)
Arthroscopy , Athletic Injuries/therapy , Immobilization , Shoulder Dislocation/therapy , Accidental Falls , Acute Disease , Adult , Athletic Injuries/surgery , Biocompatible Materials , Humans , Male , Military Personnel , Orthopedic Fixation Devices , Prospective Studies , Shoulder Dislocation/surgeryABSTRACT
Coxa saltans, or snapping hip, can be attributable to a number of causes. Coxa saltans externa typically occurs when the thickened portion of the iliotibial band snaps over the greater trochanter as the hip is flexed. This condition generally resolves with a course of nonoperative treatment. We have treated three patients with Z-plasty of the iliotibial band, which has the highest published success rate in the English language literature. Only one of three patients was able to return to full activities postoperatively. In our small series, this method of surgical treatment in an active duty military population yielded less than optimal results.
