Chronic anterior dislocation of the shoulder

The treatment of 17 chronic, unreduced anterior dislocations of the shoulder was reviewed. Eleven women and six men with on average age of 67 years (range 36 to 88 years) were studied. The duration of dislocation averaged 2.3 years (8 weeks to 8 years). Seven patients were treated without surgery despite severe functional deficits, for reasons of health or motivation. Ten were treated with surgery. One patient with preserved joint surfaces underwent open reduction and corticoid transfer to bone graft an eroded anterior glenoid. Nine patients with destroyed articular surfaces underwent unconstrained replacement orthroplosty. Humeral retroversion was increased for stability. The soft tissues were reattached, and rehabilitation was modified as with a repair of recurrent dislocations. Anterior glenoid erosion was often present and required bone grafting to support the glenoid component in four shoulders. Two chronic rotator cuff tears required repair. Nine patients were followed from 2 to 6 years, with an average of 3.9 years. The results were four excellent, four satisfactory, and one unsatisfactory. Although the reconstruction is complex, the surgical results were clearly superior to those of the nonoperative group.