shoulder
Anterior Shoulder Instability
intermediate
6 min
28 marks
6 questions
Clinical Scenario
A 22-year-old male rugby player presents with recurrent right shoulder dislocations. His first dislocation occurred 2 years ago during a tackle, requiring Emergency Department reduction. He has since had 5 further dislocations, with the most recent occurring while putting on a jacket. He reports apprehension with the arm in abduction and external rotation and avoids certain positions. He wishes to continue playing rugby.
Clinical photographs and imaging are provided.
Clinical photographs and imaging are provided.
Clinical image for Anterior Shoulder Instability
Image source: Open Access medical literature (NIH/PubMed Central) • CC-BY License
Questions
Question 1 (4 marks)
Describe the anatomy of glenohumeral stability. What are the static and dynamic stabilizers?
Question 2 (5 marks)
Describe your clinical assessment of a patient with shoulder instability. What examination findings differentiate traumatic from atraumatic instability?
Question 3 (6 marks)
What imaging would you order? How do you quantify bone loss and what are the critical thresholds?
Question 4 (5 marks)
What are the indications for surgical stabilization? Compare soft tissue repair versus bony procedures.
Question 5 (4 marks)
Describe the arthroscopic Bankart repair technique. What factors predict failure?
Question 6 (4 marks)
Describe the Latarjet procedure. What are the indications and key technical points?