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Traumatic labral tears: An unknown cause of chronic shoulder pain


1 Clinique des Cèdres, 21, rue Albert Londres, 38130 ECHIROLLES, France
2 Clinique du Mail, 43, avenue Marie Reynoard, 38100 Grenoble, France
3 Service de Traumatologie et Orthopédie, Hôpital Sud, BP 338 Av de Kimberley, 38434 ECHIROLLES CEDEX, France
4 Faculté de Médecine (UJF), Domaine de la Merci, 38700 LA TRONCHE, France

Correspondence Address:
J Barth
Clinique des Cèdres, 21, rue Albert Londres, 38130 Echirolles
France
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.32920

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Year : 2007  |  Volume : 1  |  Issue : 2  |  Page : 46-50

 

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Among 83 arthroscopies performed from January 2005 to July 2006, seven patients (two female and five male) complained about chronic shoulder pain after an initial shoulder trauma without dislocation. The mean age was 31 years (range, 23-38). None of the patients suffered from stiffness. Only one patient was found with a true apprehension sign, but all the patients presented with pain during this test. The mean preoperative Constant score was 74.4/100 (range, 59-81); the mean pain score was 3.9/15 (range, 1.5-6); the mean activity level score was 9/20 (range, 6-12); the mean mobility score was 39.6/40 (range, 38-40); the mean strength score was 22/25 (range 10-25). Arthro-CT scans were performed in all cases and revealed a labral lesion. After an initial period of conservative treatment (mean 13.3 months, range 8-22 months), shoulder arthroscopy was scheduled. The gleno-humeral investigation showed one isolated anterior Bankart lesion with a Hill Sachs lesion and a glenoid bony Bankart lesion, two double anterior and posterior Bankart lesions, one triple anterior + posterior Bankart + type II SLAP lesion and three isolated type II SLAP lesions. Arthroscopic repair was undertaken if a labral lesion was confirmed during diagnostic arthroscopy. Our lack of follow-up did not allow us to draw early conclusions. But we were concerned about the delay before recovering a full range of motion. If conservative treatment fails, computerized tomography or magnetic resonance imaging using injected contrast seems to better detect these lesions. Moreover, diagnostic arthroscopy could be performed. Arthroscopic procedures such as Bankart repair with minimal capsular shift and type II SLAP repair with minimal tension may be considered if the lesions are confirmed.






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1 Clinique des Cèdres, 21, rue Albert Londres, 38130 ECHIROLLES, France
2 Clinique du Mail, 43, avenue Marie Reynoard, 38100 Grenoble, France
3 Service de Traumatologie et Orthopédie, Hôpital Sud, BP 338 Av de Kimberley, 38434 ECHIROLLES CEDEX, France
4 Faculté de Médecine (UJF), Domaine de la Merci, 38700 LA TRONCHE, France

Correspondence Address:
J Barth
Clinique des Cèdres, 21, rue Albert Londres, 38130 Echirolles
France
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.32920

Rights and Permissions

Among 83 arthroscopies performed from January 2005 to July 2006, seven patients (two female and five male) complained about chronic shoulder pain after an initial shoulder trauma without dislocation. The mean age was 31 years (range, 23-38). None of the patients suffered from stiffness. Only one patient was found with a true apprehension sign, but all the patients presented with pain during this test. The mean preoperative Constant score was 74.4/100 (range, 59-81); the mean pain score was 3.9/15 (range, 1.5-6); the mean activity level score was 9/20 (range, 6-12); the mean mobility score was 39.6/40 (range, 38-40); the mean strength score was 22/25 (range 10-25). Arthro-CT scans were performed in all cases and revealed a labral lesion. After an initial period of conservative treatment (mean 13.3 months, range 8-22 months), shoulder arthroscopy was scheduled. The gleno-humeral investigation showed one isolated anterior Bankart lesion with a Hill Sachs lesion and a glenoid bony Bankart lesion, two double anterior and posterior Bankart lesions, one triple anterior + posterior Bankart + type II SLAP lesion and three isolated type II SLAP lesions. Arthroscopic repair was undertaken if a labral lesion was confirmed during diagnostic arthroscopy. Our lack of follow-up did not allow us to draw early conclusions. But we were concerned about the delay before recovering a full range of motion. If conservative treatment fails, computerized tomography or magnetic resonance imaging using injected contrast seems to better detect these lesions. Moreover, diagnostic arthroscopy could be performed. Arthroscopic procedures such as Bankart repair with minimal capsular shift and type II SLAP repair with minimal tension may be considered if the lesions are confirmed.






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