Clin Orthop Surg.  2016 Sep;8(3):333-338. 10.4055/cios.2016.8.3.333.

Chronic Irreducible Anterior Dislocation of the Shoulder without Significant Functional Deficit

• Chung H
• Yoon YS
• Shin JS
• Shin JJ
• Kim D

• KMID: 2374282
• DOI: http://doi.org/10.4055/cios.2016.8.3.333

Abstract

Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint. However, there are cases of even greater rarity in which chronic shoulder dislocations are asymptomatic with minimal functional or structural degeneration in the joint. These patients are usually left untreated, and most show good tolerance to their condition without developing disabling symptoms or significant functional loss over time. We report on one such patient who had a chronic shoulder dislocation for more than 2 years without receiving treatment.

Keyword

Shoulder joint; Chronic dislocation; Irreducible; Untreated

MeSH Terms

Accidental Falls
Aged
Humans
Magnetic Resonance Imaging
Male
Radiography
Range of Motion, Articular
Recurrence
*Rotator Cuff Injuries/diagnosis/diagnostic imaging/physiopathology
*Shoulder/diagnostic imaging/pathology/physiopathology
*Shoulder Dislocation/diagnosis/diagnostic imaging/physiopathology

Figure

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  Fig. 1 Gross pictures show atrophy of the deltoid muscle compared to the contralateral side (A) and prominence of the acromion's anterolateral border (B).

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  Fig. 2 On physical examination, somewhat diminished range of motion was revealed in the dislocated left shoulder joint for active forward elevation (A) and abduction (B). The patient showed severely restricted active internal posterior rotation (C) and external rotation (D).

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  Fig. 3 Simple radiography revealed the anteriorly dislocated shoulder with a Hill-Sachs lesion in the humeral head.

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  Fig. 4 (A, B) Three-dimensional computed tomography revealed an anteriorly dislocated humeral head. (C, D) A false joint was formed between the posterior portion of the humeral head and the anterior border of the glenoid.

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  Fig. 5 Magnetic resonance imaging also revealed the anteriorly dislocated humeral head with rotator cuff injury (A) and Hill-Sachs lesion (B).

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