Gregory L. Cvetanovich, MD

There has been a recent increase in ulnar collateral ligament injuries. These injuries typically occur in overhead athletes and baseball players, but can occur in athletes at all competition levels.

Demonstrated in this video is the technique of ulnar collateral ligament repair with internal brace augmentation.

Sternoclavicular joint injury is rare and accounts for about 3% of all shoulder girdle injuries. Due to the strong support of the surrounding ligamentous structures, dislocation requires a large force.

In this video, Gregory L. Cvetanovich, MD, and colleagues perform sternoclavicular joint reconstruction in a 19-year-old right hand-dominant man with pain and anterior sternoclavicular instability.

Posterior instability is less common than anterior shoulder instability, encompassing approximately 10% of all shoulder instability in young active patients. The etiology of posterior instability is most commonly traumatic dislocation or subluxation that damages the posterior labrum, posterior inferior glenohumeral ligament, and/or the bony glenoid rim (posterior bony Bankart lesion). Traumatic posterior shoulder instability or dislocation is typically seen when a posteriorly directed force is applied to a flexed adducted and internally rotated limb, which forces the humeral head posteriorly. Atraumatic chronic posterior instability is found notably in patients who frequently perform activities with repetitive posterior-directed forces, such as weight lifters or football linemen.

A 16-year-old male hockey player was checked into the boards and sustained an isolated left scapula injury. He had no past medical history and no prior injury, deformity or pain to the left shoulder or scapula. On examination, he was noted to have significant deformity of the left scapula with prominence of the inferior angle, which resulted in the clinical appearance of winging of the scapula. There was associated ecchymosis and tenderness to palpation of the scapular body. The left shoulder had mild to moderate discomfort with active and passive motion, which was full. He had no concomitant injury and was neurovascularly intact to the left upper extremity.

There has been increased awareness of sports-related concussions and risks associated with head trauma. The reported rates of concussions have doubled during the past decade, especially among youth and high school athletes. Much of the increase is attributable to greater recognition and diagnosis, as well as more media attention.