Axillary artery disruption secondary to anterior dislocation of the shoulder

Complications of shoulder dislocation

Dislocations of the shoulder are the most common joint dislocations seen in the emergency department, and complications of shoulder dislocations are more frequent than is generally believed. It is vital that emergency physicians have current knowledge of complications associated with shoulder dislocations because of their important role in recognition and prevention. Delayed recognition of complications can have an impact on the long-term outcome of patients. Prompt recognition and follow-up are essential. Most references address reduction methods rather than recognition of specific complications. Emergency physicians have few opportunities to update their knowledge of complications of shoulder dislocations. This article briefly reviews mechanisms of shoulder dislocation and discusses complications in light of the mechanisms of injury.

The capsular imbrication procedure for recurrent anterior instability of the shoulder

One hundred and thirty-eight patients (142 shoulders) who had recurrent anterior instability of the shoulder that was unresponsive to a specific physician-directed rehabilitation program were managed with an anatomical capsular imbrication reconstruction. The procedure included repair of the capsulolabral injury, when present, and reinforcement of the anteroinferior capsular ligaments with an imbrication technique that decreases the over-all capsular volume. The shoulders were divided into two groups: 108 shoulders in which the recurrent instability was related to a defined traumatic episode (Group I) and thirty-four shoulders with no distinct history of trauma (Group II). The anatomical capsular imbrication was the primary procedure in ninety shoulders and was used to treat at least one failed previous reconstruction in fifty-two shoulders. According to the grading system of Rowe et al., 93 per cent (132) of the shoulders had a good or excellent result at an average of five years (range, two or twelve years) after the operation. The results after a previous failed reconstruction were especially encouraging. Of the fifty-two shoulders that had had at least one previous reconstructive procedure, forty had an excellent result, five had a good result, four had a fair result, and three had a poor result. The results of this study suggest that this procedure restores stability while preserving a functional range of motion in patients who have symptomatic recurrent anterior instability of the shoulders, regardless of the etiology.

Axillary aneurysm after shoulder injury. A report of 2 cases

Two cases of false aneurysm of the axillary artery occurred after closed shoulder injuries. One was a dislocation of the shoulder, and the other was a fracture of the lesser tuberosity. In both cases the diagnosis was delayed, and only became apparent after excessive bruising was seen.

Vascular trauma

Civilian vascular trauma is not uncommon. Prompt treatment with modern vascular surgical techniques produces good results.