Sports clinic Paris
Metro: Saint Marcel
Parking 6 rue test
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The diagnosis is made ??on the ground. After a fall on the shoulder at the tackle generally, the player complained of a sharp pain in the shoulder, with the failure of the move. It is maintained spontaneously by the opposite arm. Felt a "ball" between the deltoid and pectoralis matching the humeral head dislocated forward. The arm is spontaneously eliminated from the body but can not move because of the intense pain.
Rugby player with a dislocated right shoulder
IT IS STRICTLY FORBIDDEN TO HANDLE ARM ATTEMPT.
If there is a fracture and not a dislocation, the risk is to move the fracture and create irreversible damage to the shoulder.
Then, wait for help to arrive, which will transport the player to an emergency service. Firefighters, a doctor or an ambulance will help the player get up, hold the arm in the position and if the pain allows, protecting it in a scarf, or simply wrap the shirt around the arm.
An x-ray is necessary and indispensable to confirm the diagnosis and rule out other diagnoses (including fractures).
Luxation is the dislocation of the joint between the humerus and scapula.
The plating is involved in 2/3 of cases. Or if it concerns the tackled player (75% of cases), while falling to the ground with direct trauma on the top of the shoulder or at the tackle (25% of cases) with the arm position is reinforced hit by the tackled player. 62% of dislocations are recurrences.
Reminder on the shoulder dislocation:
The dislocation is severe trauma that systematically generates anatomical lesions of the joint.
Most often (90% of cases) the dislocation is in front of the joint, on in the armed movement, arm and elbow back. More rarely, back, arms forward, the elbow directly impacted from front to back.
The consequences of dislocation
The gleno humeral joint (between the humeral bone and shoulder blade) is held by the tendons of shoulder muscles, ligaments, capsular shell, with a reinforcement around the scapula called "bead".
The shoulder is a very mobile joint, in the various spatial planes. This mobility is necessarily accompanied by a risk of instability.
Each dislocation, there is damage to the ligaments of the bead, or lesions type fracture. The passage of the head of the humerus "in force" can lead to fracture of the posterior part of the humeral head and / or front of the shoulder blade.
Others feared complications are fractures and nerve damage. The nerves can be stretched or cut less frequently. Generally, the axillary nerve is stretched: which causes anesthesia of the shoulder and a deficit of forward flexion of the shoulder deficiency of the anterior bundle of deltoid. More rarely, it is all the nerves of the arm called the brachial plexus, which can be stretched or broken, resulting in paralysis of the whole arm.
The risks of dislocation
Partial ACL tear
Isolated ruptures of the anterior cruciate ligament (ACL) injuries are the most frequent ligament of the knee. These breaks may be complete or partial. In partial tears, clinical diagnosis is more difficult because the clinical presentation is variable. The diagnosis, evolution in time and treatment its partial tears are still subject to much controversy. The purpose of this article is to clarify the definitions, clinical diagnosis and therapeutic strategies to these partial ACL tears. (read more ...)
Women have four to eight times more likely than men to have a ruptured anterior cruciate ligament (ACL). This risk seems more important during the pre-ovulatory phase of the menstrual cycle than during the post-ovulatory phase. The main objective of the study was to describe the distribution of ACL injuries during the menstrual cycle in a large recreational skiers population.
The main goal of this study Was to compare the results of the GNRB arthrometer To Those of Telos TM in the diagnosis of partial thickness tears of the anterior cru- ciate ligament (ACL). A prospective study Performed January- December 2011 included all patients presenting with a partial or full-thickness tears ACL without ACL recon- struction and with a healthy contralateral knee. Anterior laxity Was Measured in all patients by the Telos TM and GNRB├ĺ devices.
It is necessary to distinguish:
- The fracture lesions which are always found with certainty notion traumatic (new or old)
- Chronic lesions with onset of osteonecrosis subchondral more or less extensive, described in the literature under different terminologies (osteochondrosis, osteochondritis, osteonecrosis).
This distinction seems to us essential because etiology, radiographic appearance, treatment and prognosis of such lesions are sometimes totally different.