Children and adolescents with posttraumatic shoulder instability benefit from arthroscopic stabilization.
BACKGROUND
Traumatic dislocation of the shoulder in childhood is rare, accounting for only 0.01% of all injuries in this age class. However, literature does contain indications that post-traumatic instabilities and re-dislocations occur with more than average frequency in children and adolescents.


METHODS
This study describes the technique and results of arthroscopic stabilization of the shoulder joint before the completion of growth. Over a period of four years, seven patients were treated prior to reaching skeletal maturity. Five patients were treated by means of arthroscopically assisted labral refixation using suture anchor systems.


RESULTS
Arthroscopic labral refixation for post-traumatic shoulder instability could be carried out using the same surgical procedure as in adults. Clinical follow-up was undertaken after 12 to 48 (average 26) months using modified Constant-Murley and Rowe scores. Instability, re-dislocations and postoperative impairment of mobility did not occur after arthroscopic treatment, with an average Constant score of 92 points (Rowe score >95 points).


CONCLUSIONS
This study demonstrated that this technique can be used successfully in children and young people prior to skeletal maturity. Considerable experience in adult shoulder reconstruction promises excellent results in children and adolescents, too. There was no evidence of growth disturbance or biodegradation-associated problems in this group of children and adolescents. Delay of labral refixation until adulthood is therefore not indicated.
Kraus
R
R
University Hospital Giessen, Department of Trauma Surgery, Giessen, Germany. ralf.kraus@chiru.med.uni-giessen.de
Pavlidis
T
T
Dongowski
N
N
Szalay
G
G
Schnettler
R
R
D000293:Adolescent; D001182:Arthroscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D016059:Range of Motion, Articular; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D053441:Suture Anchors; D013536:Suture Techniques / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome