EFFECTIVENESS OF SURGICAL TREATMENT FOR SENILE CHRONIC SHOULDER DISLOCATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YUDu ¹ ,  XIAOHaijun ² , SHIWeizhe ¹ , JUJinyong ²

1. Third Affiliated Clinical College of Southern Medical University, Guangzhou Guangdong, 510515, P. R. China;
2. Department of Orthopedics, Fengxian Hospital Affiliated to Southern Medical University;

Corresponding author：

XIAOHaijun, Email: xiaohaijun89@126.com

Keywords：

Chronic shoulder dislocation; Surgical treatment; Elderly patient

DOI：

10.7507/1002-1892.20150233

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Objective To investigate the surgical treatment and effectiveness of senile chronic shoulder dislocation. Methods Between October 2011 and April 2014, 7 elderly patients with chronic shoulder dislocation were treated. There were 2 males and 5 females with an average age of 74 years (range, 61-83 years). The causes of injuries were falling injury in 6 patients and traffic accident injury in 1 patient. The interval between injury and confirmed diagnosis was 4-12 weeks (mean, 6.7 weeks). Preoperative apprehension test and Dugas sign of the shoulder joint were positive. Before operation, the forward elevation, abduction, and external rotation were (50.7±8.4), (44.5±3.3), and (35.8±4.8)°, respectively; and internal rotation reached T₆, T₁₁, L₄ in 1 case and reached T₁₀, T₁₂ in 2 cases separately. The Constant-Murley score and Neer score were 51.2±8.3 and 45.4±7.3, respectively. Results All the incisions healed by first intention, and no complication of fracture or neurovascular injuries occurred. Seven patients were followed up 12-18 months (mean, 16 months), and no re-dislocation happened. At last follow-up, apprehension test and Dugas sign of the shoulder joint were negative. The forward elevation, abduction, and external rotation were significantly improved to (117.5±13.1), (72.0±4.6), and (39.0±3.4)° (t=-33.746, P=0.000; t=-30.614, P=0.000; t=-2.802, P=0.031); and internal rotation reached T₆, T₁₀, T₁₂, and L₃ in 1 case respectively, and T₁₁ in 3 cases, showing no significant difference when compared with preoperative values (Ζ=-1.732, P=0.083). The Constant-Murley score and Neer score were significantly improved to 85.4±4.3 and 84.0±4.8 when compared with preoperative score (t=-21.016, P=0.000; t=-29.518, P=0.000). Conclusion Surgical treatment of senile chronic shoulder dislocation can improve the range of motion and function of the shoulder joint obviously.

Citation： YUDu, XIAOHaijun, SHIWeizhe, JUJinyong. EFFECTIVENESS OF SURGICAL TREATMENT FOR SENILE CHRONIC SHOULDER DISLOCATION. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(9): 1076-1079. doi: 10.7507/1002-1892.20150233 Copy

1.	Guler O, Ekinci S, Akyildiz F, et al. Comparison of four different reduction methods for anterior dislocation of the shoulder. J Orthop Surg Res, 2015.[Epub ahead of print].
2.	王亦璁. 骨与关节损伤. 3版. 北京:人民卫生出版社, 2001:515-520.
3.	Robinson CM, Aderinto J. Posterior shoulder dislocations and fracture-dislocations. J Bone Joint Surg (Am), 2005, 87(3):639-650.
4.	Rouhani A, Navali A. Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous Bankart lesion repair. Sports Med Arthrosc Rehabil Ther Technol, 2010, 2:15.
5.	Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res, 1987, (214):160-164.
6.	Neer CS 2nd. Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg (Am), 1970, 52(6):1077-1089.
7.	Youm T, Takemoto R, Park BK. Acute management of shoulder dislocations. J Am Acad Orthop Surg, 2014, 22(12):761-771.
8.	Cutts S, Prempeh M, Drew S. Anterior shoulder dislocation. Ann R Coll Surg Engl, 2009, 91(1):2-7.
9.	魏浩, 龚清, 赵旭辉, 等. 陈旧性肩关节脱位合并Bankart损伤的手术治疗. 浙江临床医学, 2013, 15(9):1350-1351.
10.	Hovelius L, Nilsson JA, Nordqvist A. Increased mortality after anterior shoulder dislocation:255 patients aged 12-40 years followed for 25 years. Acta Orthop, 2007, 78(6):822-826.
11.	Goudie EB, Murray IR, Robinson CM. Instability of the shoulder following seizures. J Bone Joint Surg (Br), 2012, 94(6):721-728.
12.	Namdari S, Keenan MA. Treatment of glenohumeral arthrosis and inferior shoulder subluxation in an adult with cerebral palsy. J Bone Joint Surg (Am), 2011, 93(23):e140.
13.	Uhring J, Rey PB, Rochet S, et al. Interest of emergency arthroscopic stabilization in primary shoulder dislocation in young athletes. Orthop Traumatol Surg Res, 2014, 100(8 Suppl):S401-S408.
14.	Gigis I, Heikenfeld R, Kapinas A, et al. Arthroscopic versus conservative treatment of first anterior dislocation of the shoulder in adolescents. J Pediatr Orthop, 2014, 34(4):421-425.
15.	管英. 手术治疗陈旧性肩关节脱位5例报道. 贵州医药, 2007, 31(5):426-427.
16.	Jou HJ, Jiang CC. Modified Bankart procedure for recurrent anterior shoulder dislocation. J Formos Med Assoc, 2000, 99(6):472-476.
17.	Chandra R, Sharma VK, Mahajan S, et al. Modified Boytchev procedure for recurrent anterior dislocation of shoulder. J Orthop Surg (Hong Kong), 2014, 22(2):204-208.
18.	Boileau P, Thélu CÉ, Mercier N, et al. Arthroscopic Bristow-Latarjet combined with Bankart repair restores shoulder stability in patients with glenoid bone loss. Clin Orthop Relat Res, 2014, 472(8):2413-2424.
19.	Rahme H, Vikerfors O, Ludvigsson L, et al. Loss of external rotation after open Bankart repair:an important prognostic factor for patient satisfaction. Knee Surg Sports Traumatol Arthrosc, 2010, 18(3):404-408.
20.	Mizuno N, Denard PJ, Raiss P, et al. Long-term results of the Latarjet procedure for anterior instability of the shoulder. J Shoulder Elbow Surg, 2014, 23(11):1691-1699.
21.	Longo UG, Loppini M, Rizzello G, et al. Latarjet, Bristow, and EdenHybinette procedures for anterior shoulder dislocation:systematic review and quantitative synthesis of the literature. Arthroscopy, 2014, 30(9):1184-1211.
22.	Choo A, Sobol G, Maltenfort M, et al. Prevalence of rotator cuff tears in operative proximal humerus fractures. Orthopedics, 2014, 37(11):e968-e974.

1. Guler O, Ekinci S, Akyildiz F, et al. Comparison of four different reduction methods for anterior dislocation of the shoulder. J Orthop Surg Res, 2015.[Epub ahead of print].
2. 王亦璁. 骨与关节损伤. 3版. 北京:人民卫生出版社, 2001:515-520.
3. Robinson CM, Aderinto J. Posterior shoulder dislocations and fracture-dislocations. J Bone Joint Surg (Am), 2005, 87(3):639-650.
4. Rouhani A, Navali A. Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous Bankart lesion repair. Sports Med Arthrosc Rehabil Ther Technol, 2010, 2:15.
5. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res, 1987, (214):160-164.
6. Neer CS 2nd. Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg (Am), 1970, 52(6):1077-1089.
7. Youm T, Takemoto R, Park BK. Acute management of shoulder dislocations. J Am Acad Orthop Surg, 2014, 22(12):761-771.
8. Cutts S, Prempeh M, Drew S. Anterior shoulder dislocation. Ann R Coll Surg Engl, 2009, 91(1):2-7.
9. 魏浩, 龚清, 赵旭辉, 等. 陈旧性肩关节脱位合并Bankart损伤的手术治疗. 浙江临床医学, 2013, 15(9):1350-1351.
10. Hovelius L, Nilsson JA, Nordqvist A. Increased mortality after anterior shoulder dislocation:255 patients aged 12-40 years followed for 25 years. Acta Orthop, 2007, 78(6):822-826.
11. Goudie EB, Murray IR, Robinson CM. Instability of the shoulder following seizures. J Bone Joint Surg (Br), 2012, 94(6):721-728.
12. Namdari S, Keenan MA. Treatment of glenohumeral arthrosis and inferior shoulder subluxation in an adult with cerebral palsy. J Bone Joint Surg (Am), 2011, 93(23):e140.
13. Uhring J, Rey PB, Rochet S, et al. Interest of emergency arthroscopic stabilization in primary shoulder dislocation in young athletes. Orthop Traumatol Surg Res, 2014, 100(8 Suppl):S401-S408.
14. Gigis I, Heikenfeld R, Kapinas A, et al. Arthroscopic versus conservative treatment of first anterior dislocation of the shoulder in adolescents. J Pediatr Orthop, 2014, 34(4):421-425.
15. 管英. 手术治疗陈旧性肩关节脱位5例报道. 贵州医药, 2007, 31(5):426-427.
16. Jou HJ, Jiang CC. Modified Bankart procedure for recurrent anterior shoulder dislocation. J Formos Med Assoc, 2000, 99(6):472-476.
17. Chandra R, Sharma VK, Mahajan S, et al. Modified Boytchev procedure for recurrent anterior dislocation of shoulder. J Orthop Surg (Hong Kong), 2014, 22(2):204-208.
18. Boileau P, Thélu CÉ, Mercier N, et al. Arthroscopic Bristow-Latarjet combined with Bankart repair restores shoulder stability in patients with glenoid bone loss. Clin Orthop Relat Res, 2014, 472(8):2413-2424.
19. Rahme H, Vikerfors O, Ludvigsson L, et al. Loss of external rotation after open Bankart repair:an important prognostic factor for patient satisfaction. Knee Surg Sports Traumatol Arthrosc, 2010, 18(3):404-408.
20. Mizuno N, Denard PJ, Raiss P, et al. Long-term results of the Latarjet procedure for anterior instability of the shoulder. J Shoulder Elbow Surg, 2014, 23(11):1691-1699.
21. Longo UG, Loppini M, Rizzello G, et al. Latarjet, Bristow, and EdenHybinette procedures for anterior shoulder dislocation:systematic review and quantitative synthesis of the literature. Arthroscopy, 2014, 30(9):1184-1211.
22. Choo A, Sobol G, Maltenfort M, et al. Prevalence of rotator cuff tears in operative proximal humerus fractures. Orthopedics, 2014, 37(11):e968-e974.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF SURGICAL TREATMENT FOR SENILE CHRONIC SHOULDER DISLOCATION

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