[Diagnosis and therapeutic management following traumatic anterior shoulder dislocation according to extrinsic prognostic factors].
We examined the importance of preoperative CT- and NMR-imaging concerning the detection of a bankart-lesion by a retrospective evaluation of 36 patients with primary traumatic or posttraumatic recurrent shoulder dislocations. Because of unfavourable extrinsic prognostic factors, we advised shoulder arthroscopy and surgical stabilization in all cases. Intraoperatively 35 of 36 patients (97%) presented a bankart-lesion. Preoperatively a bankart-lesion was detected in 32 cases (91%) by CT (n = 29) or NMR (n = 7). We could predict the probability of a bankart-lesion with a high reliability by clinical evaluation alone due to several risk-factors. All patients had at least 2 unfavourable prognostic factors. Under these circumstances we could assume a bankart-lesion with a probability of 97%. Therefore in our opinion preoperative CT or NMR is not advised as standard diagnostic procedure in patients with high-risk of recurrence according to extrinsic prognostic factors. We recommend preoperative CT or NMR when the estimation of prognostic factors concerning the risk of redislocation is doubtful and in case of difficult clinical and ultrasound examination regarding shoulder laxity or rotator cuff lesions.
Ambacher
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Unfallchirurgische Klinik, Katharinenhospital Stuttgart. ThAmbacher@t-online.de
Paar
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D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001265:Athletic Injuries / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D012783:Shoulder Dislocation / Q000150:complications / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed
Diagnostik und Therapieplanung nach traumatischer ventraler Schulterluxation anhand extrinsischer Prognosefaktoren.