Anterior shoulder instability

R H Cofield, B F Kavanagh, F J Frassica
Instructional Course Lectures 1985, 34: 210-27
Techniques of reduction include direct pressure on the humeral head, leverage through the arm, and traction maneuvers. Reduction should be expeditious but gentle. The modified Stimson, abduction, and scapular manipulation methods are effective and safe--not requiring forceful pressure or leverage. Controversy continues about postreduction immobilization and rehabilitation. In younger persons (less than 30 years of age), especially athletes, the literature supports 3 to 6 weeks of immobilization followed by an extensive rehabilitation program and avoidance of sports for at least 2 to 3 months. Many factors enter into the selection of a repair method for recurrent anterior instability. They tend to favor a method that will allow identification of the pathologic condition and treatment of the Bankart lesion or capsular laxity, if present, without concomitant use of metallic internal fixation. One such repair technique is illustrated in a step-by-step sequence.

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