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The Shoulder: Skeletal Injuries and Ligamentous Instability

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Pediatric and Adolescent Sports Traumatology

Abstract

Shoulder injuries in the pediatric athletic population continue to increase with expanded participation and higher competitive levels of youth sports. Injury patterns are unique to the growing musculoskeletal system and specific to the demands of the sport involved. They could concern a direct contact from a collision or from a repetitive overhead motion. Both acute (sudden, traumatic) and chronic (long-term) injuries are common and could involve both bone capsule and ligamentous structures. It is important for the practicing orthopedic surgeon to differentiate nonoperative injuries from the urgent and potentially operative injuries. Missing such an injury in the pediatric population could be potentially life threatening or lead to long-term disability. There is controversy regarding the appropriate treatment of these adolescent athletes, including debates on injury prevention, nonsurgical treatment versus surgical treatment, and return to play after shoulder fractures, dislocations, and instability.

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References

  1. Chen FS, Diaz VA, Loebenberg M et al (2005) Shoulder and elbow injuries in the skeletally immature athlete. J Am Acad Orthop Surg 13:172–185

    PubMed  Google Scholar 

  2. Mariscalco MW (2005) Upper extremity injuries in the adolescent athlete. Sports Med Arthr Rev 19(1):17–26

    Google Scholar 

  3. Peterson CA, Peterson HA (1972) Analysis of the incidence of injuries to the epiphyseal growth plate. J Trauma 12:275–281

    Article  CAS  PubMed  Google Scholar 

  4. Snook GA (1982) Injuries in intercollegiate wrestling. A 5-year study. Am J Sports Med 10(3):142–144

    Google Scholar 

  5. Garrick JG, Requa RK (1978) Injuries in high school sports. Pediatrics 61(3):465–469

    Google Scholar 

  6. Carr D, Johnson RJ, Pope MH (1981) Upper extremity injuries in skiing. Am J Sports Med 9(6):378–83

    Google Scholar 

  7. Landin LA (1983) Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950–1979. Acta Orthop Scand Suppl 202:1–109

    Article  CAS  PubMed  Google Scholar 

  8. Van de Velde A, De Mey K, Maenhout A, Calders P, Cools AM (2011) Scapular-muscle performance: two training programs in adolescent swimmers. J Athl Train Mar-Apr 46(2):160–167

    Article  Google Scholar 

  9. Fulton MN, Albright JP, El-Khoury GY (1979) Cortical desmoid-like lesion of the proximal humerus and its occurrence in gymnasts (ringman’s shoulder lesion). Am J Sports Med 7(1):57–61

    Google Scholar 

  10. Snook GA (1985) A review of women’s collegiate gymnastics. Clin Sports Med 4(1):31–37

    Google Scholar 

  11. Sciascia A, Kibler WB (2006) The pediatric overhead athlete: what is the real problem? Clin J Sport Med 16:471–477

    Article  PubMed  Google Scholar 

  12. Putnam CA (1993) Sequential motions of body segments in striking and throwing skills: descriptions and explanations. J Biomech 26:125–135

    Article  PubMed  Google Scholar 

  13. Lyman S, Fleisig GS, Andrews JR et al (2002) Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers. Am J Sports Med 30:463–468

    PubMed  Google Scholar 

  14. Adams JE (1966) Little league shoulder: osteochondrosis of the proximal humeral epiphysis in boy baseball pitchers. Calif Med 105:22–25

    CAS  PubMed Central  PubMed  Google Scholar 

  15. Kocher MS, Waters PM, Micheli LJ (2000) Upper extremity injuries in the pediatric athlete. Sports Med 30:117–135

    Article  CAS  PubMed  Google Scholar 

  16. Davis JT, Limpisvasti O, Fluhme D, Mohr KJ, Yocum LA, Elattrache NS, Jobe FW (2009) The effect of pitching biomechanics on the upper extremity in youth and adolescent baseball pitchers. Am J Sports Med 37(8):1484–1491

    Google Scholar 

  17. Yoneda M, Nakagawa S, Mizuno N et al (2006) Arthroscopic capsular release for painful throwing shoulder with posterior capsular tightness. Arthroscopy 7(801):e1–e5

    Google Scholar 

  18. Postacchini F, Gumina S, Cinotti G (2000) Anterior shoulder dislocations in adolescents. J Shoulder Elbow Surg 9:470–474

    Article  CAS  PubMed  Google Scholar 

  19. Von Laer L (2004) Pediatric fractures and dislocations. Thieme, Stuttgart

    Google Scholar 

  20. Deyle GD, Nagel KL (2007) Prolonged immobilization in abduction and neutral rotation for a first-episode anterior shoulder dislocation. J Orthop Sports Phys Ther 37:192–198

    Article  PubMed  Google Scholar 

  21. Itoi E, Sashi R, Minagawa H, Shimizu T, Wakabayashi I, Sato K (2001) Position of immobilization after dislocation of the glenohumeral joint. A study with use of magnetic resonance imaging. J Bone Joint Surg Am 83:661–667

    PubMed  Google Scholar 

  22. Rockwood C, Matsen F (1990) The Shoulder. WB Saunders, Philadelphia

    Google Scholar 

  23. Handoll HHG, Hanchard NCA, Goodchild L, Feary J. (2006) Conservative management following closed reduction of traumatic anterior shoulder dislocation of the shoulder. Cochrane Database Syst Rev

    Google Scholar 

  24. Rowe C (1956) Prognosis in dislocations of the shoulder. J Bone Joint Surg Am 38(5):957–977

    Google Scholar 

  25. Marans H, Angel K, Schemitsch E, Wedge JH (1992) The fate of traumatic anterior dislocation of the shoulder in children. J Bone Joint Surg Am 74(8):1242–1244

    Google Scholar 

  26. Deitch J, Mehlman C, Foad S, Obbehat A, Mallory M (2003) Traumatic anterior shoulder dislocation in adolescents. Am J Sports Med 35(1):758–763

    Google Scholar 

  27. Cil A, Kocher MS (2010) Treatment of pediatric shoulder instability. J Pediatr Orthop 30:S3–S6

    Article  Google Scholar 

  28. Jakobsen BW, Johannsen HV, Suder P et al (2007) Primary repair versus conservative treatment of first-time traumatic anterior dislocation of the shoulder: a randomized study with 10-year follow-up. Arthroscopy 23:118–123

    Article  PubMed  Google Scholar 

  29. Elmlund A, Kartus C, Sernert N, Hultenheim I, Ejerhed L (2008) A long-term clinical follow-up study after arthroscopic intraarticular Bankart repair using absorbable tacks. Knee Surg Sports Traumatol Arthrosc 16:707–712

    Article  PubMed  Google Scholar 

  30. Magee T (2009) 3-T MRI of the shoulder: is MR arthrography necessary? AJR Am J Roentgenol 192:86–92

    Article  PubMed  Google Scholar 

  31. Oh JH, Kim SH, Kwak SH, Oh CH, Gong HS (2011) Results of concomitant rotator cuff and SLAP repair are not affected by unhealed SLAP lesion. J Shoulder Elbow Surg 20(1):138–145

    Google Scholar 

  32. Walch G, Boileau P, Noel E (1992) Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg 1:238–245

    Article  CAS  PubMed  Google Scholar 

  33. Heyworth BE, Williams RJ III (2009) Internal impingement of the shoulder. Am J Sports Med 37:1024–1037

    Article  PubMed  Google Scholar 

  34. Eisner EA, Roocroft JHM, Moor MA, Edmonds EW (2013) J Pediatr Orthop 33(1)

    Google Scholar 

  35. Kibler WB, Sciascia A (2010) Current concepts: scapular dyskinesis. Br J Sports Med 44:300–305

    Google Scholar 

  36. Taylor DC, Krasinski KL (2009) Adolescent shoulder injuries: consensus and controversies. J Bone Joint Surg Am 91:461–473

    Google Scholar 

  37. Johnson TR, Steinbach LS (2003) Fracture of the clavicle. In: Rosemont Ill (ed) Essentials of musculoskeletal imaging. American Academy of Orthopaedic Surgeons, pp 180–1

    Google Scholar 

  38. Sarwark JF, King EC, Luhmann SJ (2006) Proximal humerus, scapula, and clavicle. In: Beaty JA, Kasser JR (eds) Rockwood and Wilkin’s fractures in children, 6th edn. Lippincott-Raven, Philadelphia, pp 704–771

    Google Scholar 

  39. Vander Have KL, Perdue AM, Caird MS (2010) Operative versus nonoperative treatment of midshaft clavicle fractures in adolescents. J Pediatr Orthop 30(307–312):18

    Google Scholar 

  40. Rockwood CA (1982) Fractures of outer clavicle in children and adults. J Bone Joint Surg Br 64:642–649

    Google Scholar 

  41. Shah RR, Kinder J, Peelman J (2010) Pediatric clavicle and acromioclavicular injuries. J Pediatr Orthop 30:S69–S72

    Article  Google Scholar 

  42. Bae DS, Kocher MS (2006) Chronic recurrent anterior sternoclavicular joint instability: results of surgical management. J Pediatr Orthop 26:71–74

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology—“A. Gemelli” Hospital, Catholic University of Sacred Heart, l.go A. Gemelli, 8, 00168, Rome, Italy

    Vincenzo Izzo & Carlo Fabbriciani

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  1. Vincenzo Izzo
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  2. Carlo Fabbriciani
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Correspondence to Vincenzo Izzo .

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Editors and Affiliations

  1. Bambino Gesù Children's Hospital Rome, University of Cassino, Rome, Italy

    Vincenzo Guzzanti

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Izzo, V., Fabbriciani, C. (2014). The Shoulder: Skeletal Injuries and Ligamentous Instability. In: Guzzanti, V. (eds) Pediatric and Adolescent Sports Traumatology. Springer, Milano. https://doi.org/10.1007/978-88-470-5412-7_7

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  • DOI: https://doi.org/10.1007/978-88-470-5412-7_7

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5411-0

  • Online ISBN: 978-88-470-5412-7

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