Primary traumatic anterior shoulder dislocation in patients 40 years of age and older

Arthroscopy. 1998 Apr;14(3):289-94. doi: 10.1016/s0749-8063(98)70145-8.

Abstract

During three consecutive ski seasons (1991 to 1994), 125 patients 40 years of age and older without previous shoulder injuries or surgery sustained a traumatic first-time anterior shoulder dislocation. At a minimum of 2 years' follow-up, patients were contacted to determine long-term outcome and to identify factors leading to prolonged morbidity or the need for surgical intervention. Fifty-two patients were available for interview. A modified Rowe shoulder score showed 32 excellent, nine good, eight fair, and three poor results. Eighteen (35%) rotator cuff tears were subsequently identified, with only 11 (61%) of these patients obtaining an excellent or good outcome (P = .011). Of the 11 patients with a fair or poor result, seven (64%) had a rotator cuff tear. Of the 12 patients with isolated cuff tears, 84% had an excellent or good result when treated surgically, compared with 50% when treated nonsurgically. Our findings indicate that recurrence is not a frequent complication of traumatic anterior shoulder dislocation in this age-group (4%). However, prolonged morbidity secondary to rotator cuff tear is more prevalent than in a younger population. We believe early diagnosis of rotator cuff pathology by either magnetic resonance imaging (MRI) or arthrogram with subsequent surgical repair can lead to faster restoration of function and a better outcome in these select individuals.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Fractures, Bone / complications
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Rotator Cuff / surgery
  • Rotator Cuff Injuries
  • Shoulder Dislocation* / complications
  • Shoulder Dislocation* / diagnosis
  • Shoulder Dislocation* / surgery
  • Skiing / injuries*
  • Treatment Outcome