Shoulder dislocation in patients older than 60 years of age

Jose M Rapariz, Silvia Martin-Martin, Antonio Pareja-Bezares, Jose Ortega-Klein, Jose M Rapariz, Silvia Martin-Martin, Antonio Pareja-Bezares, Jose Ortega-Klein

Abstract

Purpose: Recurrent anterior shoulder dislocation in elderly patients is a little studied condition. The goal of this paper is to clarify the role of associated injuries with respect to loss of function and recurrence of dislocation.

Materials and methods: We have conducted a retrospective, descriptive study on 29 patients older than 60 years at the moment they suffered their first dislocation episode. All patients were assessed clinically (Constant test) and by imaging testing (X-ray, MRI).

Results: Nine (31.03%) out of 29 patients had a recurrent dislocation. Four of them required reconstructive surgery to maintain joint stability. Injury to the anterior support (anterior labrum, anterior glenoid rim) showed a statistically significant relation to the recurrence of dislocations. The occurrence or non-occurrence of a rotator cuff tear does have an impact on the shoulder function. The degree of rotator cuff involvement on the coronal plane does not significantly affect the shoulder's functional outcome. The tear extension on the sagittal plane does cause impairment on the Constant test.

Conclusions: Labrum and/or anterior glenoid involvement should be suspected in elderly patients presenting with recurrent shoulder dislocation. Recurrence is due to an injury in the anterior support or both (anterior and posterior), even though shoulder function gets impaired when a rotation cuff tear occurs with anterior extension on the sagittal plane. Evidence level: IV Case series.

Keywords: Shoulder dislocation; elderly; shoulder instability.

Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
(a) Cuff involvement on the coronal plane. In Stage I, the cuff edge is distal to the highest point of the humeral head. In Stage II, the torn end of the cuff is medial to that point. (b) Cuff involvement on the sagittal plane, depending on the involvement of the supraspinatus/rotator interval (A), the infraspinatus/teres minor (B), or the subscapular tendon (C)
Figure 2
Figure 2
Constant score versus the number of dislocations. Vertical axis: number of dislocations: horizontal axis, Constant score

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Source: PubMed

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