[Treatment of unreduced anterior shoulder dislocation]

We evaluated the results of treatment in six patients with unreduced chronic anterior dislocations of the shoulder. In three patients the dislocations had not been recognized by the initial treating physician. In the remaining three patients the dislocations initially had been diagnosed but reduction had failed and the dislocations had remained unreduced. In one of the six shoulders the dislocation was left unreduced. The dislocation existed for 3.5 years and there was absence of disabling functional impairment, pain or neurovascular disturbance. In five of six shoulders the function was severely impaired. One of five shoulders with an anterior dislocation of three weeks duration could be reduced by closed manipulation. Four shoulders underwent open reduction. In all patients the humeral head could be preserved. Associated osseous lesions of the glenoid or the humeral head (Hill-Sachs lesions, fractures) were treated by rotation osteotomies according to Weber and the Eden-Lange-Hybinette procedure. Preoperatively all shoulders were graded as poor. Postoperatively the results in one was graded as excellent, in three as good and in one (algodystrophy of the left arm) as fair.