Research Article| Volume 10, ISSUE 4, P304-306, May 1979

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The unstable shoulder: recurring subluxation

  • K.S. Morton
    Requests for reprints should be addressed to: Mr K. S. Morton, Division of Orthopaedics, University of British Columbia, 2740 Heather Street, Vancouver, B.C.
    Division of Orthopaedics, University of British Columbia and the Vancouver General Hospital U.K.
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      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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        • Collins H.R.
        • Wilde A.H.
        Shoulder instability in athletics.
        Orthop. Clin. North Am. 1973; 4: 759
        • Duthie R.B.
        • Ferguson A.B.
        7th ed. Mercer's Orthopaedic Surgery. Edward Arnold, London1973: 951
        • Lucas D.B.
        Biomechanics of the shoulder joint.
        Arch. Surg. 1973; 107: 425
        • Moseley H.F.
        • Overgaard B.
        The anterior capsular mechanism in recurrent anterior dislocation of the shoulder. Morphological and clinical studies with special reference to the glenoid labrum and the glenohumeral ligaments.
        J. Bone Joint Surg. 1962; 44B: 913
        • Nelson C.L.
        The use of arthrography in athletic injuries of the shoulder.
        Orthop. Clin. North Am. 1973; 4: 775
        • Rothman R.H.
        • Marvel J.P.
        • Heppenstall R.B.
        Recurrent anterior dislocation of the shoulder.
        Orthop. Clin. North Am. 1975; 6: 415
        • Rowe C.R.
        Anterior dislocation of the shoulder: prognosis and treatment.
        Surg. Clin. North Am. 1963; 43: 1609
        • Rowe C.R.
        • Sakellarides H.T.
        Factors related to recurrences of anterior dislocation of the shoulder.
        Clin. Orthop. 1961; 20: 40
        • Saha A.K.
        Dynamic stability of the glenohumeral joint.
        Acta Orthop. Scand. 1971; 42: 491
        • Salter R.B.
        Textbook of Disorders and Injuries of the Musculo-skeletal System. Williams & Wilkins, Baltimore1970: 484
        • Samilson R.L.
        • Raphael R.L.
        • Post L.
        • et al.
        Arthrography of the shoulder joint.
        Clin. Orthop. 1961; 20: 21