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Abstract
A review of operative repairs for recurring dislocation of the shoulder revealed that
a significant proportion of these operations was being done for what could best be
described as recurring subluxation of the shoulder. The presenting complaint was of
the shoulder ‘going out of joint’, but no significant trauma was recalled, dislocation
was never shown on the radiograph and none required manual reduction. The only physical
finding was apprehension on external rotation of the shoulder in abduction. Radiographs
were frequently normal and arthrography and cineradiography were not helpful in confirming
anterior displacement. The most useful preoperative information was obtained by manipulation
of the shoulder under general anaesthesia just before the surgical repair. In all
instances anterior instability could be demonstrated.
Of 99 Magnuson-Stack repairs drawn from the records of the Vancouver General Hospital
in a 3-year period, 34 proved to be examples of recurring subluxation. This high proportion
of such patients contradicts the teaching in standard orthopaedic textbooks, but substantiates
the warning of Rowe (1963) to beware of the patient whose shoulder ‘dislocates’ initially
with little evidence of injury. It also substantiates Saha's concept (1971) of inherent
shoulder instability as a contributor to the incidence of recurring dislocation.
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References
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Article info
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© 1979 Published by Elsevier Inc.
