S. Gumina et F. Postacchini, ANTERIOR DISLOCATION OF THE SHOULDER IN ELDERLY PATIENTS, Journal of bone and joint surgery. British volume, 79B(4), 1997, pp. 540-543
Of 545 consecutive patients with anterior shoulder dislocations, 108 (
20%) were aged 60 years or more at the time of injury, We reviewed and
radiographed 95 of these elderly patients after a mean follow-up of 7
.1 years, Axillary nerve injuries were seen in 9.3% of the 108 patient
s, but all recovered completely in 3 to 12 months, There were single o
r multiple recurrences of dislocation in 21 patients (22.1%), but with
in this group age had no influence on the tendency to redislocate. Tea
rs of the rotator-cuff were diagnosed by imaging studies or clinically
in 58 patients (61%), including all who had redislocations, Sixteen p
atients required surgery, Eight with a single dislocation and a cuff t
ear had only repair of the torn cuff, Of the eight patients with multi
ple dislocations requiring operation, five also had a torn cuff and ne
eded either a stabilising procedure and a cuff repair or repair of the
cuff only, All patients who were operated on had a satisfactory resul
t, with the exception of those with multiple redislocations and a cuff
tear who had repair of the cuff only. Anterior shoulder dislocation i
n elderly subjects is more common than is generally believed; 20% suff
er redislocation and 60% have a cuff tear, Operation may be needed to
repair a torn cuff or to stabilise the shoulder, Patients with multipl
e redislocations will probably require both procedures.