Bilateral Anterior Shoulder Dislocation: A Systematic Review

被引:0
|
作者
Kuhn, Andrew W. [1 ]
Landes, Emma K. [1 ,2 ]
Yu, Justin K. [1 ,2 ]
Inclan, Paul M. [1 ]
Hill, J. Ryan [1 ]
Aleem, Alexander W. [1 ]
机构
[1] Washington Univ St Louis, Dept Orthoped Surg, St Louis, MO 63130 USA
[2] Washington Univ, Sch Med, St Louis, MO USA
来源
ARCHIVES OF BONE AND JOINT SURGERY-ABJS | 2024年 / 12卷 / 05期
关键词
Bilateral; Dislocation; Instability; Shoulder; Systematic review; Trauma; FRACTURE-DISLOCATION; MECHANISMS;
D O I
10.22038/ABJS.2024.67743.3211
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objectives: To compile the existing literature on bilateral anterior shoulder dislocation (BASD) and analyze patient demographics, mechanisms of injury, injury characteristics, management, and outcome. Methods: This systematic review was conducted in accordance with Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) guidelines. Online databases, including Ovid Medline 1946-, Embase.com 1947-, Scopus 1960-, Cochrane Central, and Clinicaltrials.gov were systematically queried. Studies eligible for inclusion were case reports or case-series, documenting BASD. Two reviewers independently screened and applied a set of a priori exclusion criteria to each returned study. Data were extracted, compiled, and synthesized from each reported case of BASD. Contingency tables/Chi-Square Analyses, T-tests, and univariate regression analyses were conducted to assess relationships between different variables. Results: Eighty-one studies (87 cases of BASD) were included. Patients were 41.1 (SD +/- 19.5) years old and most were male (n=63; 72.4%). Around a quarter of patients (28.7%) had a history of epilepsy/seizures or were being worked-up for such. Younger males were more likely to have BASD due to a seizure or electrocution (P<0.05). Close to a third of cases (n=27; 31.0%) were delayed in presentation. Those sustaining seizures or electrocutions were more likely to be delayed in presentation (P=0.013). Most events resulted in simple dislocations that were closed reduced successfully. BASD resulting from seizures or electrocutions were more likely to be fracture-dislocations (P=0.018); and in younger patients with fracture-dislocations, closed reduction was more often to fail or not be attempted (P<0.05). Median follow-up was 6 months (IQR: 3 months - 12 months). Seven patients (10.6%) had complications and 4 (2.3%) demonstrated recurrent instability. Conclusion: In young males presenting with BASD without known trauma, suspicion should be high for a convulsant event. In patients with a known seizure disorder who present with chronic bilateral shoulder or arm pain, BASD should be considered and work-up should be expedited to avoid misdiagnosis. Level of evidence: V
引用
收藏
页码:306 / 327
页数:22
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