Faculty of Medicine, University of Geneva, Switzerland
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Affidea Centre de Diagnostic Radiologique de Carouge CDRC, Geneva, Switzerland
Department of Surgical Sciences, Uppsala University, Sweden
Department of Neuroradiology, University Hospital Freiburg, Germany
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Medical Research Department, Artanim Foundation, Geneva, Switzerland
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latter can lead to increased pain, decreased level of activity, prolonged absence from work and sport, and a general decrease in quality of life. 2 , 3 Apprehension can be difficult to diagnose pre- or post-operatively, as it seems more complex than
Sport Traumatology and Biomechanics Unit, Rehasport Clinic, Poznan University of Medical Sciences, Poznan, Poland
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). 10 Suspicion of a bony problem may also come from physical examination of the shoulder. In 2008, Bushnell et al, 11 presented the concept of a bony apprehension test in patients with significant bone lesions in shoulder instability. The
Department of Orthopedics, AZ Monica, Deurne, Belgium
Department of Orthopedics, AZ Monica, Deurne, and University Hospital Antwerp, Edegem, Belgium
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Department of Orthopedics, AZ Monica, Deurne, Belgium
Department of Orthopedics, AZ Monica, Deurne, and University Hospital Antwerp, Edegem, Belgium
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Department of Orthopedics, AZ Monica, Deurne, Belgium
Department of Orthopedics, AZ Monica, Deurne, and University Hospital Antwerp, Edegem, Belgium
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hypersupinated and a valgus stress along with axial load are applied to the elbow while moving from extension to flexion. The pivot-shift test on a conscious patient is considered positive with apprehension. Under general anaesthesia, the pivot-shift test is
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FORE (Foundation for Research and Teaching in Orthopedics, Sports Medicine, Trauma, and Imaging in the Musculoskeletal System), Meyrin, Switzerland
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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which used inferior apprehension or subluxation ( 20 , 32 , 35 , 50 ) and six studies where it was not explicitly mentioned ( 1 , 18 , 49 , 77 , 78 , 79 ). Figure 2 Clinical photograph showing the presence of the sulcus sign of the left
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studies, reported that before trochleoplasty, a positive apprehension test was found in 100% of patients and postoperatively a positive apprehension test was found in 20%. After surgery, the dislocation rate was 2% and the rate of subluxation was 6% at a
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mechanism, especially paying attention to dislocation of the shoulder and any residual instability. Full physical examination of the shoulder girdle both active and passive motion, strength, neurovascular status, and apprehension test is essential. Plain
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removable character of the splint. In comparative post-treatment apprehension tests, both the cylinder plaster and the splint show the same percentage of positive apprehension tests (53%) and in terms of redislocation of the patella after treatment, the
The University of Western Australia, Perth, Australia
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Clinique Victor Hugo, 5 Bis rue du Dôme 75016 Paris, France
American Hospital of Paris, 55 Boulevard du Château, 92200 Neuilly-sur-Seine, France
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Shoulder, Elbow Unit, Sportsclinicnumber1, Papiermuehlestrasse 73, 3014 Bern, Switzerland
Shoulder, Elbow and Orthopaedic Sports Medicine, Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Bern, Switzerland
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Royal Perth Hospital, Perth, Australia
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(Bankart and variants or humeral avulsion of glenohumeral ligament (HAGL)). Recurrent episodes may include further dislocations, symptomatic subluxations or apprehension. The clinical assessment, imaging and injury patterns were previously described in
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Faculty of Medicine, University of Geneva, Geneva, Switzerland
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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joint is above 105 degrees, there is apprehension above 90 degrees of abduction, or if a difference of more than 20 degrees between the two shoulders is noted. 13 , 14 Pathological laxity is often multidirectional and associated with a redundant
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indicated ( 12 ). Clinical assessment Patients with recurrent posterior shoulder instability will present with a characteristic history and clinical presentation. While posterior labral lesions can also yield pain and apprehension, posterior