Comparison of surgical and conservative treatment of shoulder instability after primary dislocation in patients over 45 years old
Introduction Shoulder dislocation is one of the most common shoulder injuries and occurs in all age groups. Methods for diagnosing and treatment of the middle and older age groups patients with acute injury currently remain open. Surgical treatment is usually applied only in cases of chronic instab...
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| Format: | Article |
| Language: | English |
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Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2022-12-01
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| Series: | Гений oртопедии |
| Subjects: |
| _version_ | 1811200700999270400 |
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| author | Alexey A. Makovsky Ruslan V. Zaytsev Vadim E. Dubrov |
| author_facet | Alexey A. Makovsky Ruslan V. Zaytsev Vadim E. Dubrov |
| author_sort | Alexey A. Makovsky |
| collection | DOAJ |
| description | Introduction Shoulder dislocation is one of the most common shoulder injuries and occurs in all age groups. Methods for diagnosing and treatment of
the middle and older age groups patients with acute injury currently remain open. Surgical treatment is usually applied only in cases of chronic instability.
However, conservative treatment in cases with a missed rotator cuff tear leads to a dysfunction of the shoulder joint and can lead to the development
of chronic pain and recurrent shoulder instability. Therefore, it is necessary to develop an algorithm for diagnosing the rotator cuff tear and to find the
most optimal methods for its surgical correction. The purpose of the study was to compare the results of conservative and surgical treatment in patients
of the middle and older age groups after traumatic dislocation of the shoulder, accompanied by rotator cuff tear. Materials and methods The study is
based on a prospective analysis of examination and treatment of 114 patients with shoulder dislocation aged 18 to 89 years. Among all patients with
rotator cuff tear, 19 patients were selected for conservative treatment and 24 patients for surgical refixation of the rotator cuff tendons. Results The result
of treatment was assessed 12 months after the surgical operation or the injury using ULCA shoulder score, DASH and ASES. It was found the scores
of patients who underwent surgery for rotator cuff tear were significantly better than in the patients treated conservatively. Conclusion Therefore, all
patients of middle and older age groups with dislocation of the shoulder should be examined for the presence of rotator cuff tear. In case the rotator cuff
is torn, surgical treatment is preferred over conservative treatment. |
| first_indexed | 2024-04-12T02:08:41Z |
| format | Article |
| id | doaj.art-27ab412076ac4c5bb02f9ecc5dc06929 |
| institution | Directory Open Access Journal |
| issn | 1028-4427 2542-131X |
| language | English |
| last_indexed | 2024-04-12T02:08:41Z |
| publishDate | 2022-12-01 |
| publisher | Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics |
| record_format | Article |
| series | Гений oртопедии |
| spelling | doaj.art-27ab412076ac4c5bb02f9ecc5dc069292022-12-22T03:52:28ZengRussian Ilizarov Scientific Center for Restorative Traumatology and OrthopaedicsГений oртопедии1028-44272542-131X2022-12-0128675575910.18019/1028-4427-2022-28-6-755-759Comparison of surgical and conservative treatment of shoulder instability after primary dislocation in patients over 45 years oldAlexey A. Makovsky0https://orcid.org/0000-0002-0794-2485Ruslan V. Zaytsev1https://orcid.org/0000-0002-6627-750XVadim E. Dubrov2https://orcid.org/0000-0001-5407-0432Lomonosov Moscow State University, Moscow, Russian Federation, Moscow Clinical Scientific Center of A.S. Loginov, Moscow, Russian FederationLomonosov Moscow State University, Moscow, Russian FederationLomonosov Moscow State University, Moscow, Russian FederationIntroduction Shoulder dislocation is one of the most common shoulder injuries and occurs in all age groups. Methods for diagnosing and treatment of the middle and older age groups patients with acute injury currently remain open. Surgical treatment is usually applied only in cases of chronic instability. However, conservative treatment in cases with a missed rotator cuff tear leads to a dysfunction of the shoulder joint and can lead to the development of chronic pain and recurrent shoulder instability. Therefore, it is necessary to develop an algorithm for diagnosing the rotator cuff tear and to find the most optimal methods for its surgical correction. The purpose of the study was to compare the results of conservative and surgical treatment in patients of the middle and older age groups after traumatic dislocation of the shoulder, accompanied by rotator cuff tear. Materials and methods The study is based on a prospective analysis of examination and treatment of 114 patients with shoulder dislocation aged 18 to 89 years. Among all patients with rotator cuff tear, 19 patients were selected for conservative treatment and 24 patients for surgical refixation of the rotator cuff tendons. Results The result of treatment was assessed 12 months after the surgical operation or the injury using ULCA shoulder score, DASH and ASES. It was found the scores of patients who underwent surgery for rotator cuff tear were significantly better than in the patients treated conservatively. Conclusion Therefore, all patients of middle and older age groups with dislocation of the shoulder should be examined for the presence of rotator cuff tear. In case the rotator cuff is torn, surgical treatment is preferred over conservative treatment.shoulder dislocationshoulder instabilityrotator cuff tear |
| spellingShingle | Alexey A. Makovsky Ruslan V. Zaytsev Vadim E. Dubrov Comparison of surgical and conservative treatment of shoulder instability after primary dislocation in patients over 45 years old Гений oртопедии shoulder dislocation shoulder instability rotator cuff tear |
| title | Comparison of surgical and conservative treatment of shoulder instability after primary dislocation in patients over 45 years old |
| title_full | Comparison of surgical and conservative treatment of shoulder instability after primary dislocation in patients over 45 years old |
| title_fullStr | Comparison of surgical and conservative treatment of shoulder instability after primary dislocation in patients over 45 years old |
| title_full_unstemmed | Comparison of surgical and conservative treatment of shoulder instability after primary dislocation in patients over 45 years old |
| title_short | Comparison of surgical and conservative treatment of shoulder instability after primary dislocation in patients over 45 years old |
| title_sort | comparison of surgical and conservative treatment of shoulder instability after primary dislocation in patients over 45 years old |
| topic | shoulder dislocation shoulder instability rotator cuff tear |
| work_keys_str_mv | AT alexeyamakovsky comparisonofsurgicalandconservativetreatmentofshoulderinstabilityafterprimarydislocationinpatientsover45yearsold AT ruslanvzaytsev comparisonofsurgicalandconservativetreatmentofshoulderinstabilityafterprimarydislocationinpatientsover45yearsold AT vadimedubrov comparisonofsurgicalandconservativetreatmentofshoulderinstabilityafterprimarydislocationinpatientsover45yearsold |