Generalised Ligament Laxity and Shoulder Dislocations after Sports Injuries

Authors: M A Akhtar, C M Robinson

References: Br J Sports Med 2010;44:i3 doi:10.1136/bjsm.2010.078972.9

This study was performed to assess the incidence of generalised ligament laxity in patients presented with shoulder dislocations.

Prospective data were collected for patients presented with shoulder dislocations between August 2008 and August 2009 under the care of a specialist shoulder surgeon including demographic details, types of dislocation, mechanism of injury and generalised ligament laxity. Clinical examination was used to assess the ligament laxity using the Beighton score. Laxity is scored on a 0-9 scale. Scores of 4 or above are indicative of generalised ligament laxity. Brighton criteria is used to diagnose benign joint hypermobility syndrome (BJHS) and use signs and symptoms along with Beighton score.

There were 82 patients with a mean age of 30 years. There were 77 male (94%) and 5 (6%) female patients. 34 patients (41%) attended after first time shoulder dislocation, 37 (45%) after recurrent shoulder dislocations and 11 (13%) for revision shoulder stabilisation. The most common cause of shoulder dislocation was sports related injuries in 48 patients (68%). The most common sports involved was rugby in 22 (46%) patients followed by football in 15 (31%) patients. 75 (91%) patients had anterior shoulder dislocations and 6 (7%) had multidirectional instability. The average Beighton score for these patients was 3.1 with a range from 0 to 9. 35 patients (43%) in this group had a Beighton score of 4 or more indicating generalised ligament laxity. 15 patients (18%) fulfilled the Brighton criteria for BJHS. 12 patients (15%) had a first degree relative with generalised ligament laxity.

The authors found that there is a high incidence (43%) of generalised ligament laxity in patients with shoulder dislocations after sports injuries. Appropriate advice should be given about the risk of shoulder dislocations in patients with generalised ligament laxity.

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