Mustafa YERLİ, Süleyman Semih DEDEOĞLU, Yunus İMREN, Ali YÜCE, Hakan GÜRBÜZ

First-time anterior shoulder dislocation after snowboardaccidents in amateur athletes

Aim: The glenoid rim fractures, bony bankart lesions and/or tuberculum majus fractures that occurred due to snowboarding-related first-time shoulder dislocations may have differences specific to these athletes. Thus, we aimed to examine the characteristics of bone lesions in cases with snowboarding-related first-time shoulder dislocation. Materials and Methods: The cases diagnosed with first-time shoulder dislocation and received a closed reduction in the emergency department between 2018 and 2020 were examined retrospectively. 18 patients with snowboarding-related dislocation, and 24 patients with first-time shoulder dislocation by a different injury mechanism other than winter sports injury mechanism were included in the study. Those with snowboarding-related injuries were classified as Group A and other cases were classified as Group B. Comparison was made between the two groups.Results: The average age was 27.11 ± 6.14 years in Group A, and 26.17 ± 5.44 years in Group B (p:0.656). There were 12 men (M) and 6 women (W) in Group A, and 16 M and 8 W in the Group B (p:0.999). The two groups were similar in terms of Hill-Sachs lesion, tuberculum majus fracture, bony bankart lesion, and additional injury (p>0.05). In the snowboarders, a relationship was found between the injured side and the lead foot (p: 0.013). There was a significant difference between the injury mechanism and the presence of Hill-Sachs lesion in the snowboarders (p:0.033).Conclusion: The characteristics of bone lesions in snowboarding-related first-time shoulder dislocations may be similar to that of shoulder dislocations occurred by different mechanisms. In snowboarding, the direction of sliding may put the shoulder at a higher risk of dislocation for a particular side. For these athletes, the injury mechanism may be a factor affecting the formation of Hill-Sachs lesion.

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1. Flørenes TW, Nordsletten L, Heir S, et al. Injuries among world cup ski and snowboard athletes. Scand J Med Sci Sports 2012;22:58-66.
2. On MG, Oh J-R, Jang Yh, et al. Epidemiologic study of shoulder injuries in the pyeong chang 2018 winter olympic games. Clin Orthop Surg 2019;11:187-91.
3. Kocher MS, Dupré MM, Feagin Jr JA. Shoulder injuries from alpine skiing and snowboarding aetiology, treatment and prevention. Sports Med 1998;25:201- 11.
4. McCall D, Safran MR. Injuries about the shoulder in skiing and Snowboarding. Br J Sports Med 2009;43:987-92.
5. Kocher MS, Feagin JA. Shoulder injuries during alpine skiing. Am J Sports Med 1996;24:665-9.
6. Tichy M. Shoulder injuries: is there a characteristic syndrome of ‘snowboarder’s shoulder’?. Int Musculoskelet Med 2008;30:80-2.
7. Olds M, Ellis R, Donaldson K, et al. Risk factors which predispose first-time traumatic anterior shoulder dislocations to recurrent instability in adults: a systematic review and meta-analysis. Br J Sports Med 2015;49:913-23.
8. Regauer M, Polzer H, Mutschler W. Neurovascular complications due to the hippocrates method for reducing anterior shoulder dislocations. World J Orthop 2014;5:57-61.
9. Cetik O, Uslu M, Ozsar BK. The relationship between hill-sachs lesion and recurrent anterior shoulder dislocation. Acta Orthop Belg 2007;73:175-8.
10. Chuang TY, Adams CR, Burkhart SS. Use of preoperative three dimensional computed tomography to quantify glenoid bone loss in shoulder instability. Arthroscopy 2008;24:376-82.
11. Robinson CM, Howes J, Murdoch H, et al. Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. J Bone Joint Surg Am 2006;88:2326-36.
12. Beighton P, Horan F. Orthopaedic aspects of the ehlersdanlos syndrome. J Bone Joint Surg Br 1969;51:444- 53.
13. Mallon WJ, Speer KP. Multidirectional instability: current concepts. J Shoulder Elbow Surg 1995;4:54- 64.
14. Idzikowski JR, Janes PC, Abbott PJ. Upper extremity snowboarding injuries ten-year results from the colorado snowboard injury survey. Am J Sports Med 2000;28:825-32.
15. Made C, Elmqvist L-G. A 10-year study of snowboard injuries in lapland sweden. Scand J Med Sci Sports 2004;14:128-33.
16. Salomonsson B, von Heine A, Dahlborn M, et al. Bony bankart is a positive predictive factor after primary shoulder dislocation. Knee Surg Sports Traumatol Arthrosc 2010;18:1425-31.
17. Wang RY, Arciero RA. Treating the athlete with anterior shoulder instability. Clin Sports Med 2008;27:631-48.
18. Smith GCS, Chesser TJS, Packham IN, et al. First time traumatic anterior shoulder dislocation: A review of current management. Injury 2013;44:406-8.
19. Auffarth A, Mayer M, Kofler B, et al. The interobserver reliability in diagnosing osseous lesions after firsttime anterior shoulder dislocation comparing plain radiographs with computed tomography scans. J Shoulder Elbow Surg 2013;22:1507-13.
20. Cutts S, Prempeh M, Drew S. Anterior shoulder dislocation. Ann R Coll Surg Engl 2009;91:2-7.
21. te Slaa RL, Wijffels MPJM, Brand R, et al. The prognosis following acute primary glenohumeral dislocation. J Bone Joint Surg [Br] 2004;86:58-64.
22. De Baere T, Deloyye C. First-time traumatic anterior dislocation of the shoulder in young adults: the position of the arm during immobilisation revisited. Acta Orthop Belg 2005;71:516-20.
23. Kralinger FS, Golser K, Wischatta R, et al. Predicting recurrence after primary anterior shoulder dislocation. Am J Sports Med 2002;30:116-20.
24. Hoelen MA, Burgers AM, Rozing PM. Prognosis of primary anterior shoulder dislocation in young adults. Arch Orthop Trauma Surg 1990;110:51-4.
25. Sachs RA, Lin D, Stone ML, et al. Can the need for future surgery for acute traumatic anterior shoulder dislocation be predicted? J Bone Joint Surg Am 2007;89:1665-74.