Objective: To investigate the surgical treatment and effectiveness of senile chronic shoulder dislocation.
Methods: Between October 2011 and April 2014, 7 elderly patients with chronic shoulder dislocation were treated. There were 2 males and 5 females with an average age of 74 years (range, 61-83 years). The causes of injuries were falling injury in 6 patients and traffic accident injury in 1 patient. The interval between injury and confirmed diagnosis was 4-12 weeks (mean, 6.7 weeks). Preoperative apprehension test and Dugas sign of the shoulder joint were positive. Before operation, the forward elevation, abduction, and external rotation were (50.7±8.4), (44.5±3.3), and (35.8±4.8), respectively; and internal rotation reached T6, T11, L4 in 1 case and reached T10, T12 in 2 cases separately. The Constant-Murley score and Neer score were 51.2±8.3 and 45.4±7.3, respectively.
Results: All the incisions healed by first intention, and no complication of fracture or neurovascular injuries occurred. Seven patients were followed up 12-18 months (mean, 16 months), and no re-dislocation happened. At last follow-up, apprehension test and Dugas sign of the shoulder joint were negative. The forward elevation, abduction, and external rotation were significantly improved to (117.5±13.1), (72.0±4.6), and (39.0±3.4)° (t= -33.746, P=0.000; t= -30.614, P=0.000; t= -2.802, P=0.031); and internal rotation reached T6, T10, T12, and L3 in 1 case respectively, and L3 in 3 cases, showing no significant difference when compared with preoperative values (Z= -1.732, P=0.083). The Constant-Murley score and Neer score were significantly improved to 85.4±4.3 and 84.0±4.8 when compared with preoperative score (t= -21.016, P=0.000; t= -29.518, P=0.000).
Conclusion: Surgical treatment of senile chronic shoulder dislocation can improve the range of motion and function of the shoulder joint obviously.