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Spectrum of operative childhood intra-articular shoulder pathology.

Edmonds EW, Roocroft JH, Parikh SN - J Child Orthop (2014)

Bottom Line: Of 108 children, labral pathology involved: 72 Zone I (16 isolated anterior), 56 Zone II (15 isolated posterior), 38 Zone III (four isolated superior), and three had an isolated Buford complex.With 94 % of intra-articular pathology being labral tears, the distribution of proportion in children differs from adults; moreover, 23 % involved only the posterior or posterosuperior labrum.Treating surgeons should be prepared to find anterior tears extending beyond the zone of a classic Bankart lesion and an association with C rotator cuff tears.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, University of California San Diego, 3030 Children's Way, Suite 410, San Diego, CA, 92123, USA, ewedmonds@rchsd.org.

ABSTRACT

Purpose: With increased sports participation and medical community awareness, there appears to be an increase in pediatric musculoskeletal injuries. Our purpose was to identify the intra-articular injury pattern seen within the pediatric shoulder.

Methods: A retrospective review was performed at two tertiary-care children's hospitals between 2008 and 2011 on all patients who underwent magnetic resonance imaging (MRI) and subsequent shoulder arthroscopy. Exclusion criteria included: girls >14 years old and boys >16 years old. Demographics, MRI and arthroscopic findings were recorded. Labral pathology was grouped: Zone I (Bankart lesions, 3-6 o'clock for right shoulder), Zone II (posterior labral lesions, 6-11 o'clock), Zone III (SLAP lesions, 11-1 o'clock), and Zone IV (anatomic variants, 1-3 o'clock).

Results: One hundred and fifteen children met criteria, mean age 14.4 years (range 8-16). There were 24 girls and 91 boys, with 70 right shoulders. Of 108 children, labral pathology involved: 72 Zone I (16 isolated anterior), 56 Zone II (15 isolated posterior), 38 Zone III (four isolated superior), and three had an isolated Buford complex. Seventy had more than one labral zone injured, and 31 (30 %) had more than two zones injured. Non-labral pathology included partial rotator cuff tears and humeral avulsions of the glenohumeral ligament.

Conclusion: With 94 % of intra-articular pathology being labral tears, the distribution of proportion in children differs from adults; moreover, 23 % involved only the posterior or posterosuperior labrum. Treating surgeons should be prepared to find anterior tears extending beyond the zone of a classic Bankart lesion and an association with C rotator cuff tears.

No MeSH data available.


Related in: MedlinePlus

Histogram demonstrating the location of labral pathology in the child shoulder
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Fig2: Histogram demonstrating the location of labral pathology in the child shoulder

Mentions: Of the 108 children with labral pathology, 72 involved Zone I with 16 isolated anterior, 56 involved Zone II with 15 isolated posterior, 38 involved Zone III with four isolated superior, and three had an isolated Buford complex at final diagnosis. Injuries were isolated to a single zone of injury in 38 (34 %) children. Seventy (65 %) children were injured in more than one labral zone, and 31 (29 %) were injured in more than two labral zones (Fig. 2). Posterior and posterosuperior pathology was recorded in 25 children, including isolated Zone II, Zone II and III, Zone II and IV, as well Zones II, III and IV (with IV really just being a Buford lesion).Fig. 2


Spectrum of operative childhood intra-articular shoulder pathology.

Edmonds EW, Roocroft JH, Parikh SN - J Child Orthop (2014)

Histogram demonstrating the location of labral pathology in the child shoulder
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4128945&req=5

Fig2: Histogram demonstrating the location of labral pathology in the child shoulder
Mentions: Of the 108 children with labral pathology, 72 involved Zone I with 16 isolated anterior, 56 involved Zone II with 15 isolated posterior, 38 involved Zone III with four isolated superior, and three had an isolated Buford complex at final diagnosis. Injuries were isolated to a single zone of injury in 38 (34 %) children. Seventy (65 %) children were injured in more than one labral zone, and 31 (29 %) were injured in more than two labral zones (Fig. 2). Posterior and posterosuperior pathology was recorded in 25 children, including isolated Zone II, Zone II and III, Zone II and IV, as well Zones II, III and IV (with IV really just being a Buford lesion).Fig. 2

Bottom Line: Of 108 children, labral pathology involved: 72 Zone I (16 isolated anterior), 56 Zone II (15 isolated posterior), 38 Zone III (four isolated superior), and three had an isolated Buford complex.With 94 % of intra-articular pathology being labral tears, the distribution of proportion in children differs from adults; moreover, 23 % involved only the posterior or posterosuperior labrum.Treating surgeons should be prepared to find anterior tears extending beyond the zone of a classic Bankart lesion and an association with C rotator cuff tears.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, University of California San Diego, 3030 Children's Way, Suite 410, San Diego, CA, 92123, USA, ewedmonds@rchsd.org.

ABSTRACT

Purpose: With increased sports participation and medical community awareness, there appears to be an increase in pediatric musculoskeletal injuries. Our purpose was to identify the intra-articular injury pattern seen within the pediatric shoulder.

Methods: A retrospective review was performed at two tertiary-care children's hospitals between 2008 and 2011 on all patients who underwent magnetic resonance imaging (MRI) and subsequent shoulder arthroscopy. Exclusion criteria included: girls >14 years old and boys >16 years old. Demographics, MRI and arthroscopic findings were recorded. Labral pathology was grouped: Zone I (Bankart lesions, 3-6 o'clock for right shoulder), Zone II (posterior labral lesions, 6-11 o'clock), Zone III (SLAP lesions, 11-1 o'clock), and Zone IV (anatomic variants, 1-3 o'clock).

Results: One hundred and fifteen children met criteria, mean age 14.4 years (range 8-16). There were 24 girls and 91 boys, with 70 right shoulders. Of 108 children, labral pathology involved: 72 Zone I (16 isolated anterior), 56 Zone II (15 isolated posterior), 38 Zone III (four isolated superior), and three had an isolated Buford complex. Seventy had more than one labral zone injured, and 31 (30 %) had more than two zones injured. Non-labral pathology included partial rotator cuff tears and humeral avulsions of the glenohumeral ligament.

Conclusion: With 94 % of intra-articular pathology being labral tears, the distribution of proportion in children differs from adults; moreover, 23 % involved only the posterior or posterosuperior labrum. Treating surgeons should be prepared to find anterior tears extending beyond the zone of a classic Bankart lesion and an association with C rotator cuff tears.

No MeSH data available.


Related in: MedlinePlus