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ORIGINAL ARTICLE
Year : 2017  |  Volume : 52  |  Issue : 2  |  Page : 79-84

Diagnosis and á la carte treatment of intra-articular painful shoulder lesions after single nondislocating traumatic event to the shoulder


Department of Orthopedic Surgery, Mansoura University Hospital, Mansoura, Egypt

Correspondence Address:
Naser M Selim
Department of Orthopedics Surgery, Mansoura University Hospital, Mansoura
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/eoj.eoj_22_17

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Background There is an intra-articular forgotten and sometimes hidden pathology that leads to post-traumatic chronic shoulder pain. Aim The aim of this study was to define the intra-articular pathology associated with chronic shoulder pain after nondislocating traumatic event and to evaluate the results of á la carte treatment of these conditions. Patients and methods Between April 2009 and November 2010, 100 patients were presented to us at the outpatient clinic in Mansoura University Hospital with shoulder pain after traumatic event. Sixty-eight patients were male and 32 patients were female. Their average age was 40.8 years (range: 27–55). Clinical examination and plain radiograph were performed for all patients. Conservative treatment was started; 80 patients had improved and 20 male patients did not improve, to whom MRI and shoulder arthroscopy and á la carte management according to the confronted intra-articular lesion(s) were performed. Results The results were assessed according to the University of California at Los Angeles shoulder score. All patients were satisfied with the results of treatment; 16 patients had excellent results, four patients had good results (>27 points), and no one had fair or poor results (<27 points) according to UCLA shoulder score. Conclusion Chondrolabral lesions, subscapularis tears, and long head of the biceps tendon tears and/or instability are important causes of shoulder pain after nondislocating shoulder trauma. Shoulder arthroscopy is both diagnostic and therapeutic for these lesions. Á la carte management including debridement, repair (arthroscopic or open), tenotomy, and capsular plication according to the confronted intra-articular lesion(s) gives excellent results in 80% of patients according to ULCA sore.


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