Multidirectional instabilities occur most commonly in the context of a recurrent shoulder dislocation . We talk about recurrent shoulder dislocation when it occurs during typical movements, without injury. This very often involves a multidirectional instability. and can be caused by:
- Anomalies in the capsular ligaments
- Dysplastic cavity ratios
- Intensified anteversion of the cavity, reduced retrotorsion of the head of the humerus
- Congenital connective tissue weakness (Ehlers-Danlos syndrome, Marfan syndrome)
- Incorrect muscular innervation
The initial dislocation in the case of recurrent shoulder dislocation is often in an anterior downwards direction and primarily occurs in adolescent patients without trauma. The residual instability is often multidirectional and frequently painless. Random dislocations mostly occur in childhood.
The treatment for multidirectional instability does not usually involve an operation. Targeted attempts to strengthen the musculature through physiotherapy are made to reduce the tendency of dislocation and subluxation. Indications for an operation depend on the frequency of the dislocations and the extent of the subjective impairment.
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