Clin Orthop Surg.  2009 Dec;1(4):188-193. 10.4055/cios.2009.1.4.188.

Traumatic Anterior Dislocation of the Shoulder: Factors Affecting the Progress of the Traumatic Anterior Dislocation

Affiliations
  • 1Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Korea. shoulderrhee@hanmail.net

Abstract

BACKGROUND
The aim of this study was to identify the factors that affect the progress of a traumatic anterior dislocation of the shoulder.
METHODS
Two hundred and thirty-eight patients (246 shoulders) with a traumatic anterior dislocation were enrolled in this study. The mean age at the time of surgery was 25 years (range, 14 to 47 years). There were 214 men and 24 women.
RESULTS
One hundred and sixty-four shoulders (67%) were younger than 20 years at the time of the first dislocation. Patients younger than 20 years showed a shorter interval of redislocation (p = 0.001) and a higher frequency of dislocation (p = 0.001). Athletic patients experienced their first dislocation at a younger age (p = 0.023) and showed a shorter interval of redislocation (p = 0.001) than their non-athetic counterparts. The incidence of classic and non-classic Bankart lesions was unaffected by age at the time of the first dislocation, interval between the first and second dislocation or the frequency of dislocation. Patients with bony Bankart lesions had a higher frequency of dislocation (p = 0.043).
CONCLUSIONS
The age at the time of the first dislocation and athletic activity were related to early redislocation and a high frequency of dislocation. Bony Bankart lesions were observed more often in patients with a higher frequency of dislocation. Early surgical treatment is a good option for young athletic patients with a bony Bankart lesion and a short interval between the first and second dislocation.

Keyword

Shoulder dislocation; Traumatic; Anterior; Prognostic factor

MeSH Terms

Adolescent
Adult
Age of Onset
Athletic Injuries/epidemiology/*pathology/surgery
Chi-Square Distribution
Child
Child, Preschool
Female
Humans
Male
Middle Aged
Prognosis
Recurrence
Retrospective Studies
Shoulder Dislocation/epidemiology/etiology/*pathology/surgery
Sports
Statistics, Nonparametric
Time Factors
Young Adult

Reference

1. Hovelius L. Anterior dislocation of the shoulder in teenagers and young adults: five-year prognosis. J Bone Joint Surg Am. 1987. 69(3):393–399.
Article
2. Hovelius L, Augustini BG, Fredin H, Johansson O, Norlin R, Thorling J. Primary anterior dislocation of the shoulder in young patients: a ten-year prospective study. J Bone Joint Surg Am. 1996. 78(11):1677–1684.
Article
3. McLaughlin HL, MacLellan DI. Recurrent anterior dislocation of the shoulder: II. A comparative study. J Trauma. 1967. 7(2):191–201.
Article
4. Rowe CR, Patel D, Southmayd WW. The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am. 1978. 60(1):1–16.
5. Arciero RA, Wheeler JH, Ryan JB, McBride JT. Arthroscopic Bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations. Am J Sports Med. 1994. 22(5):589–594.
Article
6. Simonet WT, Cofield RH. Prognosis in anterior shoulder dislocation. Am J Sports Med. 1984. 12(1):19–24.
Article
7. Wheeler JH, Ryan JB, Arciero RA, Molinari RN. Arthroscopic versus nonoperative treatment of acute shoulder dislocations in young athletes. Arthroscopy. 1989. 5(3):213–217.
Article
8. Bigliani LU, Newton PM, Steinmann SP, Connor PM, Mcllveen SJ. Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med. 1998. 26(1):41–45.
Article
9. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy. 2000. 16(7):677–694.
Article
10. Itoi E, Lee SB, Berglund LJ, Berge LL, An KN. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am. 2000. 82(1):35–46.
Article
11. Kim SH, Ha KI, Cho YB, Ryu BD, Oh I. Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up. J Bone Joint Surg Am. 2003. 85(8):1511–1518.
12. Pevny T, Hunter RE, Freeman JR. Primary traumatic anterior shoulder dislocation in patients 40 years of age and older. Arthroscopy. 1998. 14(3):289–294.
Article
13. Itoi E, Hatakeyama Y, Urayama M, Pradhan RL, Kido T, Sato K. Position of immobilization after dislocation of the shoulder: a cadaveric study. J Bone Joint Surg Am. 1999. 81(3):385–390.
Article
14. Itoi E, Sashi R, Minagawa H, Shimizu T, Wakabayashi I, Sato K. Position of immobilization after dislocation of the glenohumeral joint: a study with use of magnetic resonance imaging. J Bone Joint Surg Am. 2001. 83(5):661–667.
15. Wolf EM, Cheng JC, Dickson K. Humeral avulsion of glenohumeral ligaments as a cause of anterior shoulder instability. Arthroscopy. 1995. 11(5):600–607.
Article
16. Neviaser TJ. The anterior labroligamentous periosteal sleeve avulsion lesion: a cause of anterior instability of the shoulder. Arthroscopy. 1993. 9(1):17–21.
Article
17. Hovelius L. Incidence of shoulder dislocation in Sweden. Clin Orthop Relat Res. 1982. (166):127–131.
Article
18. Hovelius L. Shoulder dislocation in Swedish ice hockey players. Am J Sports Med. 1978. 6(6):373–377.
Article
19. Norlin R. Intraarticular pathology in acute, first-time anterior shoulder dislocation: an arthroscopic study. Arthroscopy. 1993. 9(5):546–549.
Article
20. te Slaa RL, Wijffels MP, Brand R, Marti RK. The prognosis following acute primary glenohumeral dislocation. J Bone Joint Surg Br. 2004. 86(1):58–64.
Article
Full Text Links
  • CIOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr