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Multidirectional instability: current concepts.

Publication ,  Journal Article
Mallon, WJ; Speer, KP
Published in: J Shoulder Elbow Surg
1995

Multidirectional instability (MDI) of the shoulder is a complex problem that is not yet well understood. Instability in several directions is termed MDI, but the precise definition, classification, cause, and optimal method of treatment remains elusive. The cause appears to be multifactorial, with biochemical and biomechanical abnormalities present in shoulders with MDI. The biomechanical factors responsible for preventing MDI include bony architecture, concavity-compression from the deepening of the glenoid by the labrum, stability from the ligaments, primarily the inferior glenohumeral ligament complex and the superior capsular structures, and muscular control by use of force couples, especially stabilization of the scapula. Current recommended treatment is initially nonoperative, with aggressive physical therapy aimed at strengthening the rotator cuff and the scapular stabilizers. Patients who fail to respond to a nonoperative regimen often improve with surgical stabilization, which is usually an inferior capsular shift or a variant of that procedure. After this surgery immobilization of the operated shoulder for 6 to 8 weeks is recommended by most authors.

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Published In

J Shoulder Elbow Surg

DOI

ISSN

1058-2746

Publication Date

1995

Volume

4

Issue

1 Pt 1

Start / End Page

54 / 64

Location

United States

Related Subject Headings

  • Shoulder Joint
  • Orthopedics
  • Joint Instability
  • Humans
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Mallon, W. J., & Speer, K. P. (1995). Multidirectional instability: current concepts. J Shoulder Elbow Surg, 4(1 Pt 1), 54–64. https://doi.org/10.1016/s1058-2746(10)80009-6
Mallon, W. J., and K. P. Speer. “Multidirectional instability: current concepts.J Shoulder Elbow Surg 4, no. 1 Pt 1 (1995): 54–64. https://doi.org/10.1016/s1058-2746(10)80009-6.
Mallon WJ, Speer KP. Multidirectional instability: current concepts. J Shoulder Elbow Surg. 1995;4(1 Pt 1):54–64.
Mallon, W. J., and K. P. Speer. “Multidirectional instability: current concepts.J Shoulder Elbow Surg, vol. 4, no. 1 Pt 1, 1995, pp. 54–64. Pubmed, doi:10.1016/s1058-2746(10)80009-6.
Mallon WJ, Speer KP. Multidirectional instability: current concepts. J Shoulder Elbow Surg. 1995;4(1 Pt 1):54–64.
Journal cover image

Published In

J Shoulder Elbow Surg

DOI

ISSN

1058-2746

Publication Date

1995

Volume

4

Issue

1 Pt 1

Start / End Page

54 / 64

Location

United States

Related Subject Headings

  • Shoulder Joint
  • Orthopedics
  • Joint Instability
  • Humans
  • 3202 Clinical sciences
  • 1103 Clinical Sciences