Anterior dislocation of the Shoulder in the Elderly

Recurrent dislocation of the shoulder has been exstensively studied in young and middle aged patients, whereas scarce information is available for elderly patients. Material and Methods. We analyzed the clinical records of all patients older than 60 years, who had been treated for a primary dislocation of shoulder . There were 85 females (82%) and 19 males (18%), aged 61 to years (mean 73 years). In 39 patients (37.5%) the dislocation had occurred in dominant side. A concomitant fracture of the greater tuberosity occurred in 13 patients (12.5%). The arm was immobilized in adduction for 2 to 4 weeks. The mean follow-up was 5.2 yr (range 6.2-7.6 years). All patients were interviewed and examined and underwent MRI or arthrography of the involved shoulder. Results. A recurrent dislocation occurred in 21 patients (20%), none whom had had a fracture of the greater tuberosity. One recurrence occurred in 11 patients after a mean time of 21 months (range 0.3-3 years), and two recurrences occurred in 5 patients with an interval of about year (range, 0.9-1.2 years between the dislocations); 5 patients had numerous dislocations with a mean interval of 6.4 months between recurrences. Of the 91 patients with no associated fracture, 68 had a limited range of motion and 60, including all those with recurrences of dislocation, clinical evidence of a cuff tear. Imaging studies demonstrated a cuff tear in 22 out of 25 patients. Of the 11 patients with a fracture of the greater tuberosity, 11 had a limited ROM and one showed clinical sign of a cuff tear. In none of the 3 patients undergoing imaging studies there was evidence of a cuff tear.