Recurrent posterior subluxation of the shoulder

The rare posterior form of instability syndrome of the shoulder is taken into consideration. A diagnostic protocol aimed at revealing posterior slipping of the humeral head following spontaneous movement or with stress is suggested; this involves semiological maneuvers, and the help of radiographs in specific projections and CT scan. As for treatment, the importance of physiatric treatment is emphasized, and surgery advised in young patients who do not benefit from conservative treatment. The authors prefer posterior capsulomyoplasty associated with posterior glenoplasty in forms of the pathology characterized by excessive glenoid retroversion. Finally, 4 personal cases are presented.     

Recurrent posterior instability (subluxation) of the shoulder

A retrospective survey of fifty shoulders in thirty-five patients with recurrent posterior instability revealed generally poor results of treatment, particularly of operative treatment. Only eleven of the shoulders had a primary traumatic insult as the event initiating the instability. Although forty-one of the affected shoulders demonstrated voluntary instability, it was the associated involuntary, unintentional instability of these shoulders that prompted the patients to seek medical attention. Pain and functional impairment relating to work and to the activities of daily living were not significant in most of these patients. The results of surgical reconstruction were generally poor, the recurrence rate was 50 per cent (thirteen of twenty-six shoulders), and there were complications in five of the twenty-six shoulders that had been operated on. Attention is drawn to the complication of degenerative osteoarthritis that is associated with posterior glenoid osteotomy. We advise care in the selection of patients for surgical reconstruction.     

Recurrent dislocation of the shoulder

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1. Definition, etiology, pathology, symptomatology and treatment of recurrent dislocation of the shoulder are reviewed.     

Recurrent dislocation of the shoulder

Study of 55 cases of recurrent dislocation of the shoulder treated by the operation of Bankart and Putti-Platt during 10 years. A new dislocation after the operation was present in one single case. The authors opinion is that the most important point of the technique is the correct reinsertion of the anteroinferior part of the capsule. If the glenoidal labrum is detached from the rim, the Bankart technique must be combined with the Putti-Platt. A comprehensive review of the results demonstrates that the patients are rarely disturbed by the limitation of external rotation of the operated shoulder.     

Locked posterior dislocation of the shoulder.

What the authors mean by locked dislocation of the shoulder is an inveterate posterior dislocation of the humeral head which remains locked within the glenoid cavity as a result of anatomopathological lesion. Based on an analysis of four cases a diagnostic-therapeutic protocol is proposed in which the clinical and radiographic data obtained allows for a reliable diagnosis and suitable treatment.     

Chronic posterior subluxation and dislocation of the radial head

The clinical and radiographic features of chronic posterior subluxation or dislocation of the radial head were studied in thirty-four elbows of twenty-seven patients. Three characteristic radiographic types were noted: Type I, subluxation; Type II, posterior dislocation with minimum displacement; and Type III, posterior dislocation with substantial proximal migration of the radius. Follow-up of eighteen patients (twenty-one elbows) revealed that posterior displacement did not usually cause serious functional impairment except for loss of rotation of the forearm. The least common presentation, Type-I subluxation, caused pain and clicking and was associated with late degenerative arthritis. Cosmetic deformity due to prominence of the radial head was also a cosmetic problem, particularly with Type-III dislocation.     

Bilateral posterior dislocation of the shoulder

The purpose of this article is to present two cases of bilateral posterior dislocation of the shoulder. A review of the previously reported cases reveals the rarity of this injury, its association with seizures and the frequency with which it is misdiagnosed.