Anterior shoulder dislocation in adolescents

Of 780 patients treated fbr primary anterior shoulder dislocations, 33 (4.2 %) were aged 12 to 17 years at the time of the dislocation. We clinically e valuated 28 of these patients a mean of 7.1 years after the initial disloca tion. All patients were radiographed, and 15 underwent magnetic resonance i maging or computed arthrotomography of the shoulder. The primary dislocatio n had been traumatic in 21 patients (75%) and atraumatic in 7 patients (25% ). Recurrent dislocations had occurred in 24 cases (86%), the number of rec urrences ranging From I to 30. In the group with traumatic primary dislocat ions, the rate of recurrences was 92% and the mean number of redislocations was 7 in the patients who had been 14 to 17 years of age at the time of th e initial injury, whereas the corresponding Figures were 33% and 0.3 in the patients who had been 13 years of age or less at the time of the initial i njury. Imaging studies showed a Bankart lesion in 80% of cases; each of the se patients had had a traumatic primary dislocation and was Id to 17 years old at the time of injury. During the follow-up period, operative stabilizi ng procedures had been performed in 7 cases. At follow-vp evaluations, all nonoperated patients showed clinical evidence of anterior or multidirection al instability of the involved shoulder; of the operated patients, each of those with traumatic primary dislocations reported no recurrences and had a satisfactory result, whereas both of the patients with atraumatic primary dislocations continued to have subluxation and/or dislocations of the opera ted shoulder In the 14- to 17-year-old adolescents with traumatic primary d islocations in whom imaging studies show Bankart lesions, there is an indic ation fbr pro phylactic stabilizing surgery at the time of the initial inju ry.