Arthrodèse d'épaule bilatérale comme procédure de sauvetage pour luxation récidivante antérieure et douleur permanente

Abstract

A case (male, 34 years) is described, whose particular clinical history resulted in an uncommon double-sided shoulder arthrodesis. Right and left shoulder history was overlapping in time and is briefly described for each side. Left shoulder: Dislocation and fracture of the greater tuberosity due to falling down stairs; after conservative fracture treatment increasing painful joint stiffness; open mobilisation, fixation of the greater tuberosity with a cancellous screw, and reconstruction of the supraspinatus tendon; at screw removal, subacromial decompression due to impingement; because of further painful shoulder stiffness, he finally received shoulder arthrodesis. Right shoulder: Traumatic dislocation with conservative therapy and following spontaneous dislocations; open stabilisation using staples; further painful instability being conservatively therapy-resistant; radiographically incipient omarthritis with the staples still in place; because of motion-related symptoms, replacement of the articular surface; development of an impingement syndrome; because of increasing pain and reduced mobility he received an arthrodesis 2 years after the opposite shoulder. Afterwards and during an 8-years follow up, the patient showed a functionally satisfactory result, was pain-free, and was able to carry out activities of daily living like eating and personal hygiene. It is concluded that the functional outcome justifies this unusual procedure of double-sided arthrodesis.