Die veraltete Schulterluxation - diagnostische und operative Konsequenzen

Abstract

The chronic unreduced shoulder dislocation still remains a therapeutic dilemma since diverging indications to conservative or operative treatment exist in clinical practice. To support the impact of operative procedures the case reports of five patients at age from 52-75 years with chronic unreduced anterior shoulder luxation for a period of 2-8 weeks were demonstrated. A delayed medical consultation of two patients, the good shoulder mobility in two cases which deceives the physicans and an incomplete radiologic diagnostic (only a.-p.-projection) were found as reasons of disregarding the anterior shoulder dislocation. Closed reduction was performed twice 3 and 6 weeks after injury. The remaining patients were treated surgically. A displaced bone Bankart was treated by modified Eden-Hybinette operation in two cases. The Neer capsula shift was performed in one patient with unidirectional instability without bony lesions and stable labrum. In the operative treatment of a neglected man with anterior shoulder joint fracture dislocation a humeral head resection was necessary. Following operation all patients were immobilized in a sling dressing for three weeks. At clinical follow up four patients had good results. These data underline the importance of operative shoulder stabilization in the treatment of chronic unreduced anterior shoulder dislocation.