抄録
The purpose of this study is to investigate MRA findings of initial traumatic anterior dislocation of the shoulder after 4 weeks immobilization, and to clarify the treatment.
Twenty-two shoulders with an initial traumatic anterior dislocation were evaluated. There were 17males and 5 females with an average age of 30.6 years(range18`76years). T1 weighted images in the transaxial plane were obtained after injecting 15cc of Gd-DTPA diluted by saline. MRA findings were classified into the following three types. Type I: The ligament-labral complex is detached. Type II: The ligament-labral complex is not detached. Type III: with a bony fragment. The Caspari procedure was performed in 8 cases of Type I with an apprehension sign.
There were 14 cases of type I,7 cases of type II and lcase of type III. The average age of type I was 26.4 years and of type II 31.3 years. The percentage with an apprehension sign in type I was 92.9% and in type II 14.3%. The detachment of the ligament-labral complex was confirmed by arthroscopy in 8cases treated by the Caspari procedure. After surgery, the apprehension sign disappeared in all the cases and neither dislocations nor subluxations have reccurred in any of the cases.
The ligament-labral complex was detached in 63.6% of initial traumatic anterior dislocations after 4weeks immobilization. Because the apprehension sign is liable to remain in type I, cases of this type should be treated by an arthroscopic Bankart repair, especially when we consider their age and sctivities.
