Few information is known about recurrent dislocations of the shoulder in the elderly. Material and MEthods. We analyzed the clinical records of all patients older than 60 years, who had been treated for a primary dislocation of the shoulder during the years 1988-1990. There were 121 patients, representing 24 % of all subjects trated for a primary dislocation of the shoulder. The group of study is represented by 104 patients. There were 85 females ( 82%) and 19 males (18%), aged 61 to 89 years ( mean 73ys). A concomitant fracture of the greater tuberosity ha occurred in 13 patients ( 12.5 %). The arm was immobilized in Desault for 2 to 4 weeks. The mean follow-up was 5.2 years. All patients were examined and 28 underwent MRI or arthography. Results. A recurrent dislocation occurred in 21 patients (20%), with pure dislocation. One recurrence occurred in 11 patients after a mean time of 21 months (range 0.3-3 ys) and two recurrences occurred in 5 patients with an interval of about one year (range 0.9-1.2 ys)between the dislocations; 5 patients ha numerous dislocations with a mean interval of 6.4 months between the recurrences. 68 patients with pure dislocation had a limited ROM and 60 , including all those with recurrences of dislocations, had clinical evidence of a cuff tear. Imaging studies demonstrated a cuff tear in 22 out of 25 patients. Of the 13 patients with a fracture of the greater tuberosity, 11 had a limited ROM and one showed clinical signs of a cuff tear. In none of the 3 patients undergoing imaging studies there was evidence of a cuff tear. Conclusion. 1/4 of the patients with a primary anterior shoulder dislocation are older than 60 years. 20 % of elderly patients undergoing an anterior shoulder dislocation subsequently have one or more dislocations and 5% have frequent recurrences. An associated fracture of the greater tuberosity decreases consederably the risk of recurrences. More the 2/3 of our patients with no associated fracture, and all those with recurrences, showed evidence of a cuff tear.
Anterior dislocation of the shoulder in the elderly / Postacchini, Franco; Gumina, Stefano. - In: JOURNAL OF SHOULDER AND ELBOW SURGERY. - ISSN 1058-2746. - STAMPA. - 5:(1996), pp. 58-58. (Intervento presentato al convegno 6th International Congress on Surgery of the Shoulder (ICSS) tenutosi a Helsinki, Finland and Stockholm, Sweden nel June 27-July 1 / July 2-4 , 1995).
Anterior dislocation of the shoulder in the elderly
POSTACCHINI, Franco;GUMINA, STEFANO
1996
Abstract
Few information is known about recurrent dislocations of the shoulder in the elderly. Material and MEthods. We analyzed the clinical records of all patients older than 60 years, who had been treated for a primary dislocation of the shoulder during the years 1988-1990. There were 121 patients, representing 24 % of all subjects trated for a primary dislocation of the shoulder. The group of study is represented by 104 patients. There were 85 females ( 82%) and 19 males (18%), aged 61 to 89 years ( mean 73ys). A concomitant fracture of the greater tuberosity ha occurred in 13 patients ( 12.5 %). The arm was immobilized in Desault for 2 to 4 weeks. The mean follow-up was 5.2 years. All patients were examined and 28 underwent MRI or arthography. Results. A recurrent dislocation occurred in 21 patients (20%), with pure dislocation. One recurrence occurred in 11 patients after a mean time of 21 months (range 0.3-3 ys) and two recurrences occurred in 5 patients with an interval of about one year (range 0.9-1.2 ys)between the dislocations; 5 patients ha numerous dislocations with a mean interval of 6.4 months between the recurrences. 68 patients with pure dislocation had a limited ROM and 60 , including all those with recurrences of dislocations, had clinical evidence of a cuff tear. Imaging studies demonstrated a cuff tear in 22 out of 25 patients. Of the 13 patients with a fracture of the greater tuberosity, 11 had a limited ROM and one showed clinical signs of a cuff tear. In none of the 3 patients undergoing imaging studies there was evidence of a cuff tear. Conclusion. 1/4 of the patients with a primary anterior shoulder dislocation are older than 60 years. 20 % of elderly patients undergoing an anterior shoulder dislocation subsequently have one or more dislocations and 5% have frequent recurrences. An associated fracture of the greater tuberosity decreases consederably the risk of recurrences. More the 2/3 of our patients with no associated fracture, and all those with recurrences, showed evidence of a cuff tear.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
