Age-Dependent Prognosis Following Conservative Treatment of Traumatic Anterior Shoulder Dislocation

Background:

First traumatic anterior shoulder dislocation still remains a topic of controvery regarding the factors which have an impact on the functional result and the development of chronic instability. In the presented study, criteria influencing the recurrence rate and the final outcome after conservative treatment are assessed.

Material and Methods: Between January 1989 and March 1997, 175 patients were treated conservatively. In 91 patients, a clinical and radiologic follow-up was obtained using a retrospective study design. In all patients, adequate trauma was found. Two groups were formed according to the patients' age (PY30: patients aged 30 years and younger, n = 45; PO30: patients older than 30 years, n = 46). For clinical assessment, the Rowe score was used. Bilateral shoulder ultrasaound and X-rays of the involved shoulder were obtained for radiologic evaluation.

Results: The recurrence rate was 89% in the PY30 group and 26% in the PO30 group (p < 0.05). A relationship between the immobilization period and the recurrence rate could not be found (p = 0.8). According to the Rowe score, excellent or good results were achieved in 19 patients of PY30 (42%) and in 29 patients of PO30 group (63%). However, main criteria significantly influencing the recurrence rate are the patients' age and activity level. Additionally, the presence of a Hill-Sachs lesion, glenohumeral subluxation or rotator cuff tears is important to the development of chronic instability.

Conclusion: The results of the presented study indicate the high risk of chronic instability in young and active patients following primary conservative treatment.