| Popis: |
Background: Chronic anterior dislocations of the shoulder have been reported on since White’s comments in 1741. Anatomopathologically, such cases exhibit modifications of the injured tissues (fibrosis, neo-articulation, muscle contracture, capsular, ligamentous, bone and tendon lesions) because of the longstanding unreduced humeral head. We hypothesize that the clinical status of such cases and the different lesion patterns observed in them obviate the need for conservative treatment or the use of classic open procedures. Treatment decisions also depend on clinical symptoms; patients who do not have much disability are left unreduced. Methods: The study reports on 53 non-randomized cases showing duration of dislocation of at least 3 weeks in patients aged between 20 and 75 years. The 53 patients were placed in three management categories: conservative, closed reduction and open reduction groups. Results: The results were evaluated following Rowe’s evaluation of results for chronic unreduced dislocation of the shoulder. Among the 49% of patients with open management, the overall score averaged 74 points. In 4 cases, we performed a modified Boytchev procedure, and the overall rating units averaged 81 points. Conclusion: These results show that the overall prognosis for surgical treatment is improved. This study is a Level IV case series. |
