Shoulder: Sports-Related Injuries in Children and Adolescents

Pediatric shoulder sports injuries may be due to acute macrotrauma or repetitive microtrauma. Anterior glenohumeral joint dislocations as well as associated Hill-Sachs, Bankart and multiple Bankart variant lesions such as Perthes, GLAD and ALPSA may occur acutely. Posterior glenohumeral joint dislocations, as well as associated reverse Hill-Sachs, reverse Bankart and POLPSA may also occur. Skeletally immature individuals may sustain fracture injuries to the open physes (Salter–Harris fractures) of the humeral head, glenoid, coracoid and acromion. Children also sustain clavicle fractures, acromioclavicular joint separations, and less likely, osteolysis of the distal clavicle and sternoclavicular joint separations. Myotendinous and myofascial strains, as well as soft tissue hematomas also occur in children and adolescents. Chronic overuse injuries include proximal humeral epiphysiolysis (little league shoulder), rotator cuff tendinopathy and impingement as well as rotator cuff tears. Anterior, posterior and multidirectional instability may also occur.