The incidence and characteristics of shoulder instability at the United States Military Academy.
BACKGROUND
The literature provides little information detailing the incidence of traumatic shoulder instability in young, healthy athletes.


OBJECTIVE
Shoulder instability is common in young athletes.


METHODS
Descriptive epidemiologic study.


METHODS
We prospectively captured all traumatic shoulder instability events at the United States Military Academy between September 1, 2004, and May 31, 2005. Throughout this period, all new traumatic shoulder instability events were evaluated with physical examination, plain radiographs, and magnetic resonance imaging. Instability events were classified according to direction, chronicity, and type (subluxation or dislocation). Subject demographics, mechanism of injury, and sport were evaluated.


RESULTS
Among 4141 students, 117 experienced new traumatic shoulder instability events during the study period; 11 experienced multiple events. The mean age of these 117 subjects was 20.0 years; 101 students were men (86.3%), and 16 were women (13.7%). The 1-year incidence proportion was 2.8%. The male incidence proportion was 2.9% and the female incidence proportion was 2.5%. Eighteen events were dislocations (15.4%), and 99 were subluxations (84.6%). Of the 99 subluxations, 45 (45.5%) were primary events, while 54 (54.5%) were recurrent. Of the 18 dislocations, 12 (66.7%) were primary events, while 6 (33.3%) were recurrent. The majority of the 117 events were anterior in nature (80.3%), while 12 (10.3%) were posterior, and 11 (9.4%) were multidirectional. Forty-four percent (43.6%) of the instability events experienced were as a result of contact injuries, while 41.0% were a result of noncontact injuries, including 9 subluxations caused by missed punches during boxing; information was unavailable for the remaining 15%.


CONCLUSIONS
Glenohumeral instability is a common injury in this population, with subluxations comprising 85% of instability events.
Owens
Brett D
BD
Orthopaedic Surgery Service, Keller Army Hospital, US Military Academy, West Point, NY 10996, USA. b.owens@us.army.mil
Duffey
Michele L
ML
Nelson
Bradley J
BJ
DeBerardino
Thomas M
TM
Taylor
Dean C
DC
Mountcastle
Sally B
SB
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007593:Joint Instability / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008889:Military Personnel; D009518:New York / Q000453:epidemiology; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012307:Risk Factors; D012783:Shoulder Dislocation / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D000070599:Shoulder Injuries; D013334:Students; D014481:United States / Q000453:epidemiology