[The unstable shoulder in young subjects. Surgical experience]

The stability of the scapulo humeral joint depends on three anatomical factors: bony: surface and integrity of the glenoid cavity. ligamentous: joint capsula and labrum glenoïdale. muscular: coordination and condition of the components of the rotator cuff that maintains the humeral head in the center of the joint, whatever be the position of the arm. Clinically, the most frequent aspect is the anterior recurrent dislocation, occurring in young patients.... Other forms are possible: posterior, multi directional, associated with a lesion of the rotator cuff in elderly patients.... Lately a new aspect was described: the painful and unstable shoulder. It is observed in high level sportsmen, who practice throwing sports. The only treatment is surgical. Two kinds of techniques are currently used: preglenoid transfer of the coracoid process, and different kinds-of capsuloplasty. Arthroscopy allows a more precise diagnose, but is not yet a good therapeutic procedure. Surgical treatment avoids recurrence in more than 95% of cases, but clinical osteoarthritis of the gleno humeral joint is observed in about 10% of cases after a long follow up (more than 10 years).