STP860

    Shoulder Dislocations Resulting from Ski Injuries

    Published: Jan 1985


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    Abstract

    A retrospective study based on 1338 dislocations seen by eleven ski resort consulting rooms was conducted with a survey of the different types of occurrence related to this injury, as well as a statistical analysis concerning the distribution by sex, age, level of sports achievement, and other factors. The different lesions associated with bones, nerves, or joint capsules are discussed. Correlations were established between the occurrence of these complications and different factors such as the type of initial fall, the patient's age, the degree of pain, and the difficulty of reduction. Of these complications, 88% were reduced in the doctor's office at the resort by simple manipulation without the use of general anesthesia. The description of these techniques is given, as well as therapeutic guidelines. A comparison is made between the percentage of success in reduction, the doctor's experience, and the technique employed. The different types of immobilization—flexible retention, cast, and elastic—are described, and the value of each of these techniques is discussed in relation to the initial diagnosis, the patient's age, and the primitive or recurrent character of the dislocation. The duration of immobilization prescribed and adhered to, the physical therapy undertaken, and the eventual sequelae are compared. A new type of retention is presented. We explain how it is possible to undertake an immediate rehabilitation without compromising the consolidation of capsular dislocations. A statistical evaluation based on these dislocations analyzes the different factors of recurrence: the patient's age at the first dislocation, type of initial fall, type and duration of immobilization, rehabilitation, time elapsed between the initial accident and the reduction, technique of rehabilitation, study of associated lesions, recurrence after surgical intervention, and research on associated lesions. A questionnaire sent to these patients enabled us to evaluate the pain felt before, during, and after the reduction and, the eventual complications: limitation of range of motion, neurological sequelae, and pain or discomfort under stress. It was also found that there is no correlation between the occurrence of these sequelae and the patient's age at the first lesion or the delay before reduction. Half of these lesions have left a residual effect, according to the patients, the major complaint being a limitation of range of motion in the shoulder articulation. One third of the patients, however, presented no complications and complained of no residual effects after the initial accident. Dislocation of the shoulder is often wrongly considered to be a trivial lesion. We have tried to show its management in emergency cases. We enumerate some preventive measures, which should limit the number of these injuries, the frequency of which is at present increasing.

    Keywords:

    shoulder dislocation, ski injuries, skiing trauma, skiing safety


    Author Information:

    Binet, Marc-Hervé
    Member, Medical Committee of the French Ski Federation, and president, French Society for Skiing Safety, Avoriaz,

    Berrehail, Mohamed
    Member, French Society of Ski Resorts Doctors, Les Deux Alpes,

    Montillet, Bernard
    Member, French Society of Ski Resorts Doctors, Veyrier du Lac,

    Terrenoir, Francois
    Member, French Society of Ski Resorts Doctors, Notre Dame de Bellecombe,

    Tissier, Bruno
    Member, French Society of Ski Resorts Doctors, Flaine,


    Paper ID: STP46655S

    Committee/Subcommittee: F27.65

    DOI: 10.1520/STP46655S


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