title: Prevalence of associated injuries after anterior shoulder dislocation: a prospective study.
abstract: OBJECTIVE
  Anterior shoulder dislocation can be associated with many lesions such as Bankart lesions, rotator cuff tears (RCT), Hill-Sachs lesions or greater tuberosity fractures. It has been documented that early management of the associated injury affords better recovery of shoulder function. The aim of this study was to highlight the incidence of associated injuries after anterior shoulder dislocation.
  
  
  METHODS
  A total of 240 patients with traumatic anterior glenohumeral dislocations were subjected to complete history taking, neurovascular assessment and pre-reduction plain X-ray. An X-ray was taken immediately after reduction. Ultrasonography (US) and magnetic resonance imaging (MRI) were done within one week after reduction in all patients. Nerve conduction studies were ordered for any patient with suspected nerve injury.
  
  
  RESULTS
  Associated lesions were reported in 144 (60%) patients. RCT was the most common injury (67 cases). It was isolated in 34 patients (14.15%), while it was combined with other lesions in 33 cases (13.75%). Axillary nerve injury was encountered in 38 patients, of them 8 (3.33%) were isolated and 30 (12.5%) were combined. Greater tuberosity fracture was found in 37 patients, of them 15 (6.25%) were combined with axillary nerve injury, and in the other 22 patients (9.17%) the fracture was isolated. All cases with Hill-Sachs and Bankart lesion were combined lesions with no isolated cases. There was a significant relation between the incidence of associated injuries and age, mechanism of injury and the affected side.
  
  
  CONCLUSIONS
  Lesions associated with traumatic anterior glenohumeral dislocations are more frequent than expected. Thorough clinical examination and detailed imaging including US and MRI are mandatory to avoid a missed diagnosis.
authors.affiliation: Orthopedic Department, Tanta University, Tanta, Egypt. ashraf19970@yahoo.com.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Atef
authors.affiliation: Orthopedic Department, Tanta University, Tanta, Egypt.
authors.forename: Ahmad
authors.initials: A
authors.lastname: El-Tantawy
authors.affiliation: Orthopedic Department, Tanta University, Tanta, Egypt.
authors.forename: Hossam
authors.initials: H
authors.lastname: Gad
authors.affiliation: Radiology Department, Tanta University, Tanta, Egypt.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Hefeda
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059348:Peripheral Nerve Injuries / Q000453:epidemiology* / Q000209:etiology; D010808:Physical Examination; D015995:Prevalence; D011446:Prospective Studies; D000070636:Rotator Cuff Injuries; D012783:Shoulder Dislocation / Q000150:complications* / Q000503:physiopathology; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology
keywords: Bankart lesions; Rotator cuff tear; Shoulder dislocation; Shoulder imaging