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[Post-traumatic shoulder instability in adolescence].

B G Ochs1, M Rickert, N Schmelzer-Schmied

  • 1Orthopädische Universitätsklinik Heidelberg.

Der Orthopade
|October 14, 2004
PubMed
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Adolescent post-traumatic shoulder instability leads to high recurrence rates. Operative treatment after skeletal maturity can reduce recurrence and improve sports function in young patients.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Pediatric Traumatology

Background:

  • Post-traumatic shoulder instability is uncommon in adolescents but frequently leads to recurrent dislocations.
  • Early dislocations in this age group often result in persistent instability.

Purpose of the Study:

  • To evaluate outcomes of conservative and operative treatments for adolescent post-traumatic shoulder instability.
  • To determine recurrence rates and return to sports activity based on treatment and age at injury.

Main Methods:

  • Retrospective study of 32 patients under 16 years old with initial shoulder dislocation.
  • Follow-up averaged 5 years, analyzing age at first dislocation, injury type, and treatment results.
  • Comparison of recurrence and return-to-sport rates between conservative (age <15) and operative (age >15) groups.

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Main Results:

  • 94% (30/32) of patients experienced recurrent shoulder dislocations.
  • Operative group (age >15): 36.5% recurrence rate, 71% returned to sports.
  • Conservative group (age <15): 50% recurrence rate, 50% returned to sports.

Conclusions:

  • Both conservative and operative treatments show high recurrence rates in adolescent post-traumatic shoulder instability.
  • Operative intervention following skeletal maturity (glenoid ossification) is associated with lower recurrence and improved sports participation.
  • Age at the time of injury and skeletal maturity are critical factors in treatment decision-making and outcomes.