Summary
We have reviewed the history of 154 primary, traumatic dislocations of the shoulder in order to determine the risk of recurrence. We found a recurrence rate of 68% in patients under the age of 20, after a follow-up period of 1–9 years (average 4.5 years). There was a highly significant difference (p<0.0001) in the recurrence rate of patients under, and above, 30 years of age. Twenty per cent of the patients had a concurrent minor fracture at the shoulder with 2 out of 39 of the recurrent cases (5%) and 29 of the 115 non-recurrent cases (25%); this is also a significant difference (p<0.01). Neither the need for general anaesthesia at primary injury nor the occupation of the patient was a relevant factor in the final outcome of the dislocation. Four nerve injuries were encountered (3%), with no severe sequelae at follow-up. The young patient with no concurrent fracture at the time of the primary shoulder dislocation has a high risk of recurrence.
Résumé
Afin d'évaluer le risque de récidive, on a revu 154 observations de luxations traumatiques primitives. 68% des patients âgés de moins de 20 ans ont présenté une récidive après une période variant de 1 à 9 ans (4.5 ans en moyenne). Le pourcentage de récidive, au dessus ou au dessous de l'âge de 30 ans, diffère de façon hautement significative (p<0.001). Vingt pour cent des cas présentaient également une fracture mineure de l'épaule, parmi lesquels 2 sur les 39 cas de récidive (5%) et 29 sur les 115 cas de non-récidive (25%). Cette différence est également significative (p<0.01). Ni la nécessité d'une anesthésie générale à l'occasion de la première réduction, ni le métier du patient n'étaient des facteurs influant sur le résultat final. Quatre lésions nerveuses (3%) ont été observées, aucune n'a entraîné de séquelles. Chez les patients jeunes qui présentent une première luxation de l'épaule sans fracture, le risque de récidive est très élevé.
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Vermeiren, J., Handelberg, F., Casteleyn, P.P. et al. The rate of recurrence of traumatic anterior dislocation of the shoulder. International Orthopaedics 17, 337–341 (1993). https://doi.org/10.1007/BF00180449
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DOI: https://doi.org/10.1007/BF00180449