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Shoulder Terrible Triad: Classification, Functional Results, and Prognostic Factors.
Marsalli, Michael; Sepúlveda, Oscar; Morán, Nicolás; Breyer, Juan Manuel.
Afiliação
  • Marsalli M; From the Orthopaedic Department, Hospital del Trabajador and Clínica Universidad de los Andes (Dr. Marsalli), Orthopaedic Department, Hospital del Trabajador (Dr. Sepúlveda and Dr. Morán), and Orthopaedic Department, Hospital del Trabajador and Clínica Alemana (Dr. Breyer), Santiago, Chile.
J Am Acad Orthop Surg ; 28(5): 200-207, 2020 Mar 01.
Article em En | MEDLINE | ID: mdl-31904675
INTRODUCTION: The shoulder terrible triad (STT) is a traumatic anterior shoulder dislocation, associated with rotator cuff (RC) tear and nerve injury from the brachial plexus. This study aimed to describe the functional results and prognostic factors of surgery in patients with STT. METHODS: Thirty consecutive patients with acute STT were included at the same institution. All patients were examined with x-rays, MRI, and electromyography. Surgical treatment in the acute setting was indicated to address an RC injury or a displaced greater tuberosity fracture. Variables registered on the day of surgery were preoperative Constant and Western Ontario Rotator Cuff (WORC) scores and injury pattern. At final discharge, Constant, American Shoulder and Elbow Surgeons (ASES), WORC, and subjective shoulder value scores were recorded by an independent evaluator. RESULTS: Twenty-seven patients underwent a complete follow-up. The dominant arm was affected in 50% of cases. The mean follow-up was 27 (12 to 43) months. The mean WORC and Constant scores improved from 1,543 to 1,093 (P = 0.015) and 31 to 54 (P = 0.003), respectively. The ASES and subjective shoulder value scores at the end of the follow-up were 60 and 56 points, respectively. RC tears and nerve injuries that did not involve the axillary or suprascapular nerves were associated to better results than greater tuberosity fractures and injuries to the axillary or suprascapular nerves, respectively, in WORC (P = 0.028), Constant (P = 0.024), and ASES scores (P = 0.035). Preoperative WORC and Constant scores were independent prognostic factors. CONCLUSIONS: The most frequent patterns include complete RC tears, anterior capsular injuries, and an axillary nerve injury. Patients had improved functional scores at the end of follow-up after surgery. Better functional results were correlated to RC tears, injuries to nerves with innervation distal to the shoulder, and higher preoperative Constant and WORC scores.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Luxação do Ombro / Fraturas do Ombro / Plexo Braquial / Lesões do Manguito Rotador Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Acad Orthop Surg Assunto da revista: ORTOPEDIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Chile País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Luxação do Ombro / Fraturas do Ombro / Plexo Braquial / Lesões do Manguito Rotador Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Acad Orthop Surg Assunto da revista: ORTOPEDIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Chile País de publicação: Estados Unidos