The rate of recurrence of traumatic anterior dislocation of the shoulder

Abstract

We have reviewed the history of 154 primary, traumatic dislocations of the shoulder in order to determine the risk of recurrence. We found a recurrence rate of 68% in patients under the age of 20, after a follow-up period of 1-9 years (average 4.5 years). There was a highly significant difference (p < 0.0001) in the recurrence rate of patients under, and above, 30 years of age. Twenty per cent of the patients had a concurrent minor fracture at the shoulder with 2 out of 39 of the recurrent cases (5%) and 29 of the 115 non-recurrent cases (25%); this is also a significant difference (p < 0.01). Neither the need for general anaesthesia at primary injury nor the occupation of the patient was a relevant factor in the final outcome of the dislocation. Four nerve injuries were encountered (3%), with no severe sequelae at follow-up. The young patient with no concurrent fracture at the time of the primary shoulder dislocation has a high risk of recurrence.

The assessment of shoulder instability

“…3 Frank dislocation may result from injury, and recurrence is very common after traumatic dislocation. 1,2,4 Less often, the condition arises from congenital abnormality of the ligaments and capsule of the joint and is then more likely to be multidirectional. In some cases the condition responds well to physiotherapy, but a number of different operations have been recommended to stabilise the joint.…”

Assessment of Capsular Insertion Type and of Capsular Elongation in Patients with Anterior Shoulder Instability and It's Correlation with Surgical Outcome: A Quantitative Assessment with Computed Tomography Arthrography

“…Known factors other than ones concerning anatomy to influence anterior shoulder instability include age at first dislocation, gender, hyperlaxity, fracture of the greater tuberosity, and etc. [25][26][27] In a recent systematic review, which analyzed the results of six retrospective cohort studies, it was reported that the risk factors implicated in inducing the transition from a dislocation episode to anterior shoulder instability were age of less than 14 years, male sex, and etc.…”

Current Concepts in Rehabilitation for Traumatic Anterior Shoulder Instability

“…Vermeiren et al reported that those with recurrent instability event after an anterior shoulder dislocation reported significant lower visits with a physiotherapist (average of 15 daily sessions) versus those who did not have a recurrent instability event (average 47 daily sessions) [16]. In contrast, however, Kralinger et al found that the age-adjusted rate of participation in physical therapy showed no association with recurrent instability [17].…”

“…Phase III: Minimal Protection Phase After Anterior Labral Repair (12)(13)(14)(15)(16)(17)(18)(19)(20) Weeks)…”