search for




 

Traumatic anterior shoulder dislocation in elderly patients
Arthrosc Orthop Sports Med 2016;3:24-31
Published online January 1, 2016;  https://doi.org/10.14517/aosm15010
© 2016 Arthroscopy and Orthopedic Sports Medicine.

Sang-Jin Shin, Young-Won Ko, Juyeob Lee

Ewha Shoulder Disease Center, Department of Orthopedic Surgery, Ewha Womans University School of Medicine, Seoul, Korea
Correspondence to: Sang-Jin Shin, Department of Orthopedic Surgery, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea. Tel: +82-2-2650-5143, Fax: +82-2-2650-5144, E-mail: sjshin622@ewha.ac.kr
Received June 8, 2015; Revised July 2, 2015; Accepted August 20, 2015.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The prevalence of traumatic anterior shoulder dislocations in the elderly population has increased because of prolonged life expectancy. Clinical manifestations and prognosis of shoulder dislocations in the elderly are known to differ from those of the younger population. The accurate diagnosis of associated injuries such as rotator cuff tears and anterior capsulolabral lesions is critical for the recovery of shoulder function, for failure to do so may lead to recurrent shoulder dislocation. Especially, the rotator cuff tears have been shown to be the predominant pathological lesion in the majority of elderly patients. Treatment was chosen on the basis of the size of the rotator cuff tear, the presence of an anterior capsulolabral lesion, and the history of dislocations. A satisfactory clinical outcome without recurrence of the disease can be obtained by early detection of injuries and by appropriate application of treatment modalities.
Keywords : Shoulder dislocation; Aged; Rotator cuff tears; Anterior capsulolabral lesion
References
  1. Maier M, Geiger EV, Ilius C, Frank J, Marzi I. Midterm results after operatively stabilised shoulder dislocations in elderly patients. Int Orthop 2009;33:719-23.
    Pubmed KoreaMed CrossRef
  2. Porcellini G, Paladini P, Campi F, Paganelli M. Shoulder instability and related rotator cuff tears: arthroscopic findings and treatment in patients aged 40 to 60 years. Arthroscopy 2006;22:270-6.
    Pubmed CrossRef
  3. Rowe CR. Prognosis in dislocations of the shoulder. J Bone Joint Surg Am 1956;38:957-77.
    Pubmed
  4. Rowe CR, Sakellarides HT. Factors related to recurrences of anterior dislocations of the shoulder. Clin Orthop 1961;20:40-8.
    Pubmed
  5. Kaz?r B, Relovszky E. Prognosis of primary dislocation of the shoulder. Acta Orthop Scand 1969;40:216-24.
    Pubmed CrossRef
  6. Gumina S, Postacchini F. Anterior dislocation of the shoulder in elderly patients. J Bone Joint Surg Br 1997;79:540-3.
    Pubmed CrossRef
  7. Rapariz JM, Martin-Martin S, Pareja-Bezares A, Ortega-Klein J. Shoulder dislocation in patients older than 60 years of age. Int J Shoulder Surg 2010;4:88-92.
    Pubmed KoreaMed CrossRef
  8. Levy O, Pritsch M, Rath E. An operative technique for recurrent shoulder dislocations in older patients. J Shoulder Elbow Surg 1999;8:452-7.
    CrossRef
  9. Gyftopoulos S, Albert M, Recht MP. Osseous injuries associated with anterior shoulder instability: what the radiologist should know. AJR Am J Roentgenol 2014;202:W541-50.
    Pubmed CrossRef
  10. Restrepo Gonz?lez R. Direct magnetic resonance arthrography, indirect magnetic resonance arthrography, and computed tomography arthrography for rotator cuff lesions and superior labral an-terior and posterior tears: state of the art. Radiologia 2013;55:283-93.
    Pubmed CrossRef
  11. Pevny T, Hunter RE, Freeman JR. Primary traumatic anterior shoulder dislocation in patients 40 years of age and older. Arthroscopy 1998;14:289-94.
    CrossRef
  12. Shin SJ, Yun YH, Kim DJ, Yoo JD. Treatment of traumatic anterior shoulder dislocation in patients older than 60 years. Am J Sports Med 2012;40:822-7.
    Pubmed CrossRef
  13. de Laat EA, Visser CP, Coene LN, Pahlplatz PV, Tavy DL. Nerve lesions in primary shoulder dislocations and humeral neck fractures. A prospective clinical and EMG study. J Bone Joint Surg Br 1994;76:381-3.
    Pubmed
  14. Hawkins RJ, Bell RH, Hawkins RH, Koppert GJ. Anterior dislocation of the shoulder in the older patient. Clin Orthop Relat Res 1986;(206):192-5.
    CrossRef
  15. Gates JD, Knox JB. Axillary artery injuries secondary to anterior dislocation of the shoulder. J Trauma 1995;39:581-3.
    Pubmed CrossRef
  16. Apaydin N, Tubbs RS, Loukas M, Duparc F. Review of the surgical anatomy of the axillary nerve and the anatomic basis of its iatrogenic and traumatic injury. Surg Radiol Anat 2010;32:193-201.
    Pubmed CrossRef
  17. Mclaughlin HL. Dislocation of the shoulder with tuberosity fracture. Surg Clin North Am 1963;43:1615-20.
    Pubmed
  18. Platzer P, Kutscha-Lissberg F, Lehr S, Vecsei V, Gaebler C. The influence of displacement on shoulder function in patients with minimally displaced fractures of the greater tuberosity. Injury 2005;36:1185-9.
    Pubmed CrossRef
  19. Neviaser RJ, Neviaser TJ, Neviaser JS. Concurrent rupture of the rotator cuff and anterior dislocation of the shoulder in the older patient. J Bone Joint Surg Am 1988;70:1308-11.
    Pubmed
  20. Berbig R, Weishaupt D, Prim J, Shahin O. Primary anterior shoulder dislocation and rotator cuff tears. J Shoulder Elbow Surg 1999;8:220-5.
    CrossRef
  21. Simank HG, Dauer G, Schneider S, Loew M. Incidence of rotator cuff tears in shoulder dislocations and results of therapy in older patients. Arch Orthop Trauma Surg 2006;126:235-40.
    Pubmed CrossRef
  22. Pouliart N, Gagey O. Concomitant rotator cuff and capsuloligamentous lesions of the shoulder: a cadaver study. Arthroscopy 2006;22:728-35.
    Pubmed CrossRef
  23. Shin SJ, Yoo JC, McGarry MH, Jun BJ, Lee TQ. Anterior capsulolabral lesions combined with supraspinatus tendon tears: biomechanical effects of the pathologic condition and repair in human cadaveric shoulders. Arthroscopy 2013;29:1492-7.
    Pubmed CrossRef
  24. Robinson CM, Kelly M, Wakefield AE. Redislocation of the shoulder during the first six weeks after a primary anterior dislocation:risk factors and results of treatment. J Bone Joint Surg Am 2002;84:1552-9.
    Pubmed
  25. Yamamoto A, Takagishi K, Osawa T, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg 2010;19:116-20.
    Pubmed CrossRef
  26. Atoun E, Narvani A, Even T, et al. Management of first-time dislocations of the shoulder in patients older than 40 years: the prevalence of iatrogenic fracture. J Orthop Trauma 2013;27:190-3.
    Pubmed CrossRef
  27. Neviaser RJ, Neviaser TJ, Neviaser JS. Anterior dislocation of the shoulder and rotator cuff rupture. Clin Orthop Relat Res 1993;(291):103-6.
    CrossRef
  28. Itoi E, Tabata S. Rotator cuff tears in anterior dislocation of the shoulder. Int Orthop 1992;16:240-4.
    CrossRef
  29. Araghi A, Prasarn M, St Clair S, Zuckerman JD. Recurrent anterior glenohumeral instability with onset after forty years of age: the role of the anterior mechanism. Bull Hosp Jt Dis 2005;62:99101.
  30. Ji JH, Shafi M, Song IS, Kim YY, McFarland EG, Moon CY. Arthroscopic fixation technique for comminuted, displaced greater tuberosity fracture. Arthroscopy 2010;26:600-9.
    Pubmed CrossRef
  31. McLaughlin HL, MacLellan DI. Recurrent anterior dislocation of the shoulder. II. A comparative study. J Trauma 1967;7:191-201.
    Pubmed CrossRef
  32. Hsu HC, Luo ZP, Cofield RH, An KN. Influence of rotator cuff tearing on glenohumeral stability. J Shoulder Elbow Surg 1997;6:41322.
    CrossRef
  33. Jouve F, Graveleau N, Nov?-Josserand L, Walch G. Recurrent anterior instability of the shoulder associated with full thickness rotator cuff tear: results of surgical treatment. Rev Chir Orthop Reparatrice Appar Mot 2008;94:659-69.
    Pubmed CrossRef
  34. Hsu HC, Boardman ND 3rd, Luo ZP, An KN. Tendon-defect and muscle-unloaded models for relating a rotator cuff tear to glenohumeral stability. J Orthop Res 2000;18:952-8.
    Pubmed CrossRef


November 2024, 11 (2)