Glenoid bone loss in traumatic glenohumeral instability in the adolescent population

Henry Bone Ellis, Max Seiter, Kelsey Wise, Philip Wilson

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Glenoid bone loss can affect the outcome and treatment for posttraumatic recurrent anterior glenohumeral instability. Clinical presentation in the adolescent age group with shoulder instability and glenoid bone loss is largely unknown. On the basis of this information, we believe there will be a high incidence of glenoid bone loss in adolescent patients with recurrent glenohumeral instability. We hypothesize that high-impact injuries, sports injuries, and reductions requiring sedation will be factors associated with glenoid bone loss. Methods: We performed a retrospective cross-sectional cohort study reviewing consecutive adolescent patients (n=114) with recurrent traumatic glenohumeral instability between 2004 and 2012. Chart analysis included demographic, presenting, and radiographic data. Glenoid bone loss was interpreted from plain radiographs, computed tomography (2D and/or 3D), magnetic resonance imaging, and/or arthroscopy. We compared possible risk factors between subjects with and without glenoid bone defects using the χ 2 test or 2 sample t tests. Results: Glenoid bone loss was seen in 55 patients (48.2%) with 15 of these patients (27%) having critical bone loss. Forty-five percent of appreciated glenoid bone loss was not visualized on plain radiographs. The average age was 15.1 years (range, 6.5 to 18.1) with male to female ratio 3.7:1. Male sex, older age, and taller stature were all statistically associated with glenoid bone loss (P=0.02, 0.01, and 0.02, respectively). Primary dislocations that occurred during sports were more likely to have glenoid bone loss (55.9% vs. 78.2%, P=0.01). The presence of an apprehension sign on physical examination was positively correlated with bone loss (P=0.008). Conclusions: The presence of glenoid bone loss in primary traumatic glenohumeral instability in the adolescent population is high, however, not as high as previously reported. Factors associated with glenoid bone loss include male sex, older age, taller stature, sports injuries, and the presence of apprehension on physical examination.

Original languageEnglish (US)
Pages (from-to)30-35
Number of pages6
JournalJournal of Pediatric Orthopaedics
Volume37
Issue number1
DOIs
StatePublished - Jan 1 2017

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Bone and Bones
Population
Athletic Injuries
Physical Examination
Arthroscopy
Sports
Cohort Studies
Age Groups
Cross-Sectional Studies
Tomography
Magnetic Resonance Imaging
Demography
Incidence
Wounds and Injuries

Keywords

  • adolescent
  • glenoid bone loss
  • shoulder instability

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

Cite this

Glenoid bone loss in traumatic glenohumeral instability in the adolescent population. / Ellis, Henry Bone; Seiter, Max; Wise, Kelsey; Wilson, Philip.

In: Journal of Pediatric Orthopaedics, Vol. 37, No. 1, 01.01.2017, p. 30-35.

Research output: Contribution to journalArticle

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abstract = "Background: Glenoid bone loss can affect the outcome and treatment for posttraumatic recurrent anterior glenohumeral instability. Clinical presentation in the adolescent age group with shoulder instability and glenoid bone loss is largely unknown. On the basis of this information, we believe there will be a high incidence of glenoid bone loss in adolescent patients with recurrent glenohumeral instability. We hypothesize that high-impact injuries, sports injuries, and reductions requiring sedation will be factors associated with glenoid bone loss. Methods: We performed a retrospective cross-sectional cohort study reviewing consecutive adolescent patients (n=114) with recurrent traumatic glenohumeral instability between 2004 and 2012. Chart analysis included demographic, presenting, and radiographic data. Glenoid bone loss was interpreted from plain radiographs, computed tomography (2D and/or 3D), magnetic resonance imaging, and/or arthroscopy. We compared possible risk factors between subjects with and without glenoid bone defects using the χ 2 test or 2 sample t tests. Results: Glenoid bone loss was seen in 55 patients (48.2{\%}) with 15 of these patients (27{\%}) having critical bone loss. Forty-five percent of appreciated glenoid bone loss was not visualized on plain radiographs. The average age was 15.1 years (range, 6.5 to 18.1) with male to female ratio 3.7:1. Male sex, older age, and taller stature were all statistically associated with glenoid bone loss (P=0.02, 0.01, and 0.02, respectively). Primary dislocations that occurred during sports were more likely to have glenoid bone loss (55.9{\%} vs. 78.2{\%}, P=0.01). The presence of an apprehension sign on physical examination was positively correlated with bone loss (P=0.008). Conclusions: The presence of glenoid bone loss in primary traumatic glenohumeral instability in the adolescent population is high, however, not as high as previously reported. Factors associated with glenoid bone loss include male sex, older age, taller stature, sports injuries, and the presence of apprehension on physical examination.",
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