Pediatric and adolescent shoulder instability

Clin Sports Med. 2013 Oct;32(4):761-79. doi: 10.1016/j.csm.2013.07.010.

Abstract

Instability of the shoulder is a common issue faced by sports medicine providers caring for pediatric and adolescent patients. A thorough history and physical examination can help distinguish traumatic instability from multidirectional or voluntary instability. A systematic understanding of the relevant imaging characteristics and individual patient disease and goals can help guide initial treatment. Given the high risk of recurrent instability, young, active patients who seek to return to competitive contact sports should consider arthroscopic stabilization after a first-time instability event. MDI should be treated initially with conservative rehabilitation. Patients who fail extensive conservative treatment may benefit from surgical stabilization. Arthroscopic techniques may now approach the results found from traditional open capsular shift procedures. Future studies should be designed to examine the outcomes in solely pediatric and adolescent populations after both conservative and operative treatment of shoulder instability.

Keywords: Adolescent; Arthroscopy; Multidirectional instability; Pediatric; Shoulder instability.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Arthroscopy / methods
  • Athletic Injuries* / diagnosis
  • Athletic Injuries* / etiology
  • Athletic Injuries* / physiopathology
  • Athletic Injuries* / therapy
  • Biomechanical Phenomena
  • Child
  • Humans
  • Joint Instability* / diagnosis
  • Joint Instability* / etiology
  • Joint Instability* / physiopathology
  • Joint Instability* / therapy
  • Medical History Taking
  • Orthopedic Procedures / methods
  • Physical Examination
  • Recurrence
  • Shoulder Dislocation* / diagnosis
  • Shoulder Dislocation* / etiology
  • Shoulder Dislocation* / physiopathology
  • Shoulder Dislocation* / therapy
  • Shoulder Injuries
  • Shoulder Joint* / physiopathology
  • Shoulder Joint* / surgery