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True congenital dislocation of shoulder: A case report and review of the literature.

Sudesh P, Rangdal S, Bali K, Kumar V, Gahlot N, Patel S - Int J Shoulder Surg (2010)

Bottom Line: With more advanced obstetric care, the incidence of first two types has drastically decreased.We report the case because of its rarity, and review the available literature on this topic.We also discuss the management options when encountered with such a rare case scenario.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India.

ABSTRACT
The dislocation of a shoulder joint in infancy is extremely rare and is usually the result of traumatic birth injuries, a sequel to brachial plexus injury, or a true congenital dislocation of shoulder. With more advanced obstetric care, the incidence of first two types has drastically decreased. We report a case of true congenital dislocation of shoulder, second of its kind, in a child who was delivered by cesarean section thereby negating any influence of trauma. We report the case because of its rarity, and review the available literature on this topic. We also discuss the management options when encountered with such a rare case scenario.

No MeSH data available.


Related in: MedlinePlus

Immediate postoperative clinical picture showing the restoration of adduction in the child
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Figure 0004: Immediate postoperative clinical picture showing the restoration of adduction in the child

Mentions: A tight contracted deltoid muscle was preventing reduction by closed manipulation under general anesthesia and therefore open reduction by the standard deltopectoral approach was carried out. The age of the child at that time was around 6 months. Intraoperative findings included anteroinferior dislocation of the head along with scarring of the deltoid muscle which probably accounted for its tightness. A proximal release of the deltoid muscle along with the subscapularis release was done. The inferior joint capsule was surprisingly found to be thickened and tight, and required excision in order to achieve reduction. The glenoid was slightly shallow but there were no other bony abnormalities. Once reduction was achieved, the shoulder was found to adduct fully [Figure 4]. However, the reduction was found to be slightly unstable with the joint being dislocatable at 60° of abduction. A shoulder spica was applied postoperatively in 30° abduction, neutral flexion, and neutral rotation.


True congenital dislocation of shoulder: A case report and review of the literature.

Sudesh P, Rangdal S, Bali K, Kumar V, Gahlot N, Patel S - Int J Shoulder Surg (2010)

Immediate postoperative clinical picture showing the restoration of adduction in the child
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3100811&req=5

Figure 0004: Immediate postoperative clinical picture showing the restoration of adduction in the child
Mentions: A tight contracted deltoid muscle was preventing reduction by closed manipulation under general anesthesia and therefore open reduction by the standard deltopectoral approach was carried out. The age of the child at that time was around 6 months. Intraoperative findings included anteroinferior dislocation of the head along with scarring of the deltoid muscle which probably accounted for its tightness. A proximal release of the deltoid muscle along with the subscapularis release was done. The inferior joint capsule was surprisingly found to be thickened and tight, and required excision in order to achieve reduction. The glenoid was slightly shallow but there were no other bony abnormalities. Once reduction was achieved, the shoulder was found to adduct fully [Figure 4]. However, the reduction was found to be slightly unstable with the joint being dislocatable at 60° of abduction. A shoulder spica was applied postoperatively in 30° abduction, neutral flexion, and neutral rotation.

Bottom Line: With more advanced obstetric care, the incidence of first two types has drastically decreased.We report the case because of its rarity, and review the available literature on this topic.We also discuss the management options when encountered with such a rare case scenario.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India.

ABSTRACT
The dislocation of a shoulder joint in infancy is extremely rare and is usually the result of traumatic birth injuries, a sequel to brachial plexus injury, or a true congenital dislocation of shoulder. With more advanced obstetric care, the incidence of first two types has drastically decreased. We report a case of true congenital dislocation of shoulder, second of its kind, in a child who was delivered by cesarean section thereby negating any influence of trauma. We report the case because of its rarity, and review the available literature on this topic. We also discuss the management options when encountered with such a rare case scenario.

No MeSH data available.


Related in: MedlinePlus