Chronic Unreduced Anterior Shoulder Dislocation Managed by Latarjet Procedure: A Prospective Study.

Abhishek K Rai,Devanshu Gupta,Dixit Bansal,Ajinkya R Bandebuche,Ajay Naidu

doi:10.7759/cureus.21769

Abstract

The shoulder joint is the most common joint to undergo dislocation, with the anterior subtype being the most common. The most accepted definition of chronic dislocation is a shoulder joint that has remained dislocated for a minimum of three weeks. Due to rare presentation, there is a lack of consensus among surgeons regarding the optimal management option of chronic shoulder dislocation. The goal of this prospective study was to assess the efficacy of open reduction with Latarjet procedure in the management of chronic unreduced shoulder dislocation. A total of seven patients were included in this study. Five patients were males and two were females. The study was conducted in a single tertiary care centre between July 2015 and May 2018. All patients were managed by open reduction with the Latarjet procedure. The capsulolabral structures were repaired in all the cases. The post-operative functional outcome was assessed by shoulder range, Rowe score, and the University of California, Los Angeles (UCLA) score at regular intervals for a period of one year. There was a significant improvement in terms of pain relief and functional status of the patients. The patients were satisfied as they could do their daily routine activities without pain at a one-year follow-up. Early post-operative rehabilitation and physiotherapy are key to improving the functional range.

Highlights

The shoulder joint is the most common joint to undergo dislocation, with the anterior subtype being the most common [1]
The post-operative functional outcome was assessed by shoulder range, Rowe score, and the University of California, Los Angeles (UCLA) score
Similar trends were noticed in the UCLA and Rowe scores

Summary

Introduction

The shoulder joint is the most common joint to undergo dislocation, with the anterior subtype being the most common [1]. Chronic anterior shoulder dislocation is an entity known to be rare in orthopaedics. Most commonly, it occurs in the elderly population due to soft tissue weakness and degeneration around the affected shoulder joint. Alcoholism, epilepsy, and repetitive trauma predispose a young patient to undergo chronic dislocation of the shoulder. Though few studies stress the point that chronic anterior dislocation does not limit the functional status of the shoulder joint, it does affect the function [4]. The Latarjet procedure, originally described in 1954, is effective in the management of chronic anterior shoulder dislocations if the glenoid bone loss exceeds 25%. This study highlights the effectiveness and functional outcome of patients with chronic anterior shoulder dislocation managed by the Latarjet procedure. The post-operative functional outcome was assessed by shoulder range, Rowe score, and the University of California, Los Angeles (UCLA) score

Methods

Results

Discussion

Conclusion