Posterior Instability in Shoulder

Rhee, Yong Girl; Kwon, Oh Soo; Jeong, Ki Woong

Abstract

Posterior instability of the shoulder is far less common than anterior or multidirectional instability. There is still controversy in the diagnosis and treatment of recurrent posterior instability, and many treatment protocols have been advocated. However the failure rate as high as 50% was reported. The purpose of this study is to introduce characteristic physical findings of posterior instability, to present our operative techniques, and to report the efficacy of a superior shift of the postero-inferior capsule in the treatment of recurrent posterior instability. From June 1995 to September 1996, five patients, six shoulders underwent postero-inferior capsular shift for posterior instahility and were evaluated at an average of 17 months(ranged from 9 to 26 months) after operation. The average age was 22.4 years. Preoperatively, mean scores of pain, stability and function according to American Shoulder and Elbow Society (ASES) scoring system were 21, 9, and 16 points respectively and mean overall ASES score was 46 points. After surgery, the average range of motion was 175 of forward elevation and 74 of external rotation and internai rotation in back was up to the sixth thoracic level. Postoperative mean scores of pain, stability and function were 29, 34 and 25 points respectively and mean overall ASES score was 88.5 points. No patient had a recurrence of posterior instability. All patients had satisfactory results with significant improvement in stability and function except one case who had multidirectional instability that mainly involved the posterior component