[Development of habitual shoulder dislocation]

The starting point of the retrospective analysis of 177 primary dislocations was the question of frequency of habitual dislocations, the correlation between habitual dislocation and time of early immobilisation, as well as the search for additional statements which would result in a differentiated therapy. 18.1% habitual dislocations were seen to develop, mostly after immobilisation for less than three weeks. It is an interesting fact that the technique of immobilisation made no difference. We found that after the first even there was generally no loss in function, whereas 14.5% of the men and 34.3% of the women complained of severe subjective symptoms. The 12 patients who underwent an operation because of habitual dislocation suffered neither from dysfunction nor from painful movement, and no dislocation was found. The rate of habitual dislocation in our patients showed a lower rate of dislocation of the shoulder joint. We found 18.1% dislocations, whereas the literature showed an average quota of 30%. To improve the results we recommend a special X-ray technique following the first reposition. In the age group between 20 and 30 years, which is most susceptible, we also recommend arthrography and arthroscopy of the shoulder joint. To improve typical lesions, such as osseous rupture of the capsule or what is known as Hill-Sachs lesions, primary operation is discussed as an alternative treatment.