Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent Population
Paediatric and adolescent shoulder instability is caused by a unique combination of traumatic factors, ligamentous laxity, and pattern of muscle contractility. The multifactorial nature of its aetiology makes interpretation of the literature difficult as nomenclature is also highly variable. The pur...
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| Format: | Article |
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/3/724 |
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| author | Aziz Rawal Franziska Eckers Olivia S. H. Lee Bettina Hochreiter Kemble K. Wang Eugene T. Ek |
| author_facet | Aziz Rawal Franziska Eckers Olivia S. H. Lee Bettina Hochreiter Kemble K. Wang Eugene T. Ek |
| author_sort | Aziz Rawal |
| collection | DOAJ |
| description | Paediatric and adolescent shoulder instability is caused by a unique combination of traumatic factors, ligamentous laxity, and pattern of muscle contractility. The multifactorial nature of its aetiology makes interpretation of the literature difficult as nomenclature is also highly variable. The purpose of this review is to summarize the existing literature and shed light on the nuances of paediatric and adolescent shoulder instability. The epidemiology, clinical features, imaging, and management of all forms of paediatric shoulder instability are presented. The main findings of this review are that structural abnormalities following a dislocation are uncommon in pre-pubertal paediatric patients. Young post-pubertal adolescents are at the highest risk of failure of non-operative management in the setting of traumatic instability with structural abnormality, and early stabilisation should be considered for these patients. Remplissage and the Latarjet procedure are safe treatment options for adolescents at high risk of recurrence, but the side-effect profile should be carefully considered. Patients who suffer from instability due to generalized ligamentous laxity benefit from a structured, long-term physiotherapy regimen, with surgery in the form of arthroscopic plication as a viable last resort. Those who suffer from a predominantly muscle patterning pathology do not benefit from surgery and require focus on regaining neuromuscular control. |
| first_indexed | 2024-03-08T03:55:00Z |
| format | Article |
| id | doaj.art-c4c6ed88c53a4f649aae20928fa4d167 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T03:55:00Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c4c6ed88c53a4f649aae20928fa4d1672024-02-09T15:15:44ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113372410.3390/jcm13030724Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent PopulationAziz Rawal0Franziska Eckers1Olivia S. H. Lee2Bettina Hochreiter3Kemble K. Wang4Eugene T. Ek5Melbourne Orthopaedic Group, Windsor, Melbourne, VIC 3181, AustraliaMelbourne Orthopaedic Group, Windsor, Melbourne, VIC 3181, AustraliaVictorian Paediatric Rehabilitation Service, The Royal Children’s Hospital, Melbourne, VIC 3052, AustraliaMelbourne Orthopaedic Group, Windsor, Melbourne, VIC 3181, AustraliaDepartment of Orthopaedic Surgery, The Royal Children’s Hospital, Melbourne, VIC 3052, AustraliaMelbourne Orthopaedic Group, Windsor, Melbourne, VIC 3181, AustraliaPaediatric and adolescent shoulder instability is caused by a unique combination of traumatic factors, ligamentous laxity, and pattern of muscle contractility. The multifactorial nature of its aetiology makes interpretation of the literature difficult as nomenclature is also highly variable. The purpose of this review is to summarize the existing literature and shed light on the nuances of paediatric and adolescent shoulder instability. The epidemiology, clinical features, imaging, and management of all forms of paediatric shoulder instability are presented. The main findings of this review are that structural abnormalities following a dislocation are uncommon in pre-pubertal paediatric patients. Young post-pubertal adolescents are at the highest risk of failure of non-operative management in the setting of traumatic instability with structural abnormality, and early stabilisation should be considered for these patients. Remplissage and the Latarjet procedure are safe treatment options for adolescents at high risk of recurrence, but the side-effect profile should be carefully considered. Patients who suffer from instability due to generalized ligamentous laxity benefit from a structured, long-term physiotherapy regimen, with surgery in the form of arthroscopic plication as a viable last resort. Those who suffer from a predominantly muscle patterning pathology do not benefit from surgery and require focus on regaining neuromuscular control.https://www.mdpi.com/2077-0383/13/3/724shoulder instabilityshoulder dislocationpaediatricadolescenttraumatic instabilityatraumatic instability |
| spellingShingle | Aziz Rawal Franziska Eckers Olivia S. H. Lee Bettina Hochreiter Kemble K. Wang Eugene T. Ek Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent Population Journal of Clinical Medicine shoulder instability shoulder dislocation paediatric adolescent traumatic instability atraumatic instability |
| title | Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent Population |
| title_full | Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent Population |
| title_fullStr | Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent Population |
| title_full_unstemmed | Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent Population |
| title_short | Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent Population |
| title_sort | current evidence regarding shoulder instability in the paediatric and adolescent population |
| topic | shoulder instability shoulder dislocation paediatric adolescent traumatic instability atraumatic instability |
| url | https://www.mdpi.com/2077-0383/13/3/724 |
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