Abstract
11 patients (7 girls and 4 boys) with multidirectional instability of the shoulder were treated between 1999 and 2000. The average age was 15 years 8 months (range, 14–17), with a follow-up of 1 year 6 months. In the examination under general anesthesia it was confirmed that the luxation had more than one direction. The surgery was performed with general anesthesia using a standard arthroscope with video camera and classic approach for the shoulder. In order to decrease the capsular volume, capsular plicature and retraction by heat were used The plicatures were anterior, inferior and posterior.
Patients were immobilized postoperatively in plaster splints or casts during 3 weeks and then they were placed in a rehabilitation program. The patients were followed up postoperatively, the UCLA Score was used during this period. Results were excellent and good in 90% of the patients, who were pain free and had full external rotation. Only one patients (10%) presented recurrence of the instability.
Patients showed the same pre surgical sport performance. Only one case presented capsule laxity and an open surgery was performed. This patient was reexamined and was labeled as a psychiatric case wrongly selected. Only 2 patients presented capsule inflammation with limited external rotation. They were treated with intensive rehabilitation.
The arthroscopic method allows for capsular volume reduction. Results were similar to the ones described with the open technique. The reduction of the capsular volume is done mixing capsular plicature and retraction by heat.
This arthroscopic techniques, previously described for adult patients with multidirectional instability, proved to be useful in adolescents.
