During three consecutive ski seasons (1991 to 1994), 125 patients 40 years of age and older without previous shoulder injuries or surgery sustained a traumatic first-time anterior shoulder dislocation.
At a minimum of 2 years'follow-up, patients were contacted to determine long-term outcome and to identify factors leading to prolonged morbidity or the need for surgical intervention.
Fifty-two patients were available for interview.
A modified Rowe shoulder score showed 32 excellent, nine good, eight fair, and three poor results.
Eighteen (35%) rotator cuff tears were subsequently identified, with only 11 (61%) of these patients obtaining an excellent or good outcome (P=011).
Of the 11 patients with a fair or poor result, seven (64%) had a rotator cuff tear.
Of the 12 patients with isolated cuff tears, 84% had an excellent or good result when treated surgically, compared with 50% when treated nonsurgically.
Our findings indicate that recurrence is not a frequent complication of traumatic anterior shoulder dislocation in this age-group (4%). However, prolonged morbidity secondary to rotator cuff tear is more prevalent than in a younger population.
We believe early diagnosis of rotator cuff pathology by either magnetic resonance imaging (MRI) or arthrogram with subsequent surgical repair can lead to faster restoration of function and a better outcome in these select individuals.
Mots-clés Pascal : Luxation, Antérieur, Epaule, Récidivant, Etiologie, Pronostic, Rupture tissu, Coiffe rotateur, Complication, Epidémiologie, Sport, Ski, Age, Adulte, Homme, Vieillard, Membre supérieur, Ceinture thoracique, Système ostéoarticulaire pathologie, Traumatisme, Juxtaarticulaire pathologie
Mots-clés Pascal anglais : Luxation, Anterior, Shoulder, Recurrent, Etiology, Prognosis, Tissue rupture, Rotator cuff, Complication, Epidemiology, Sport, Skiing, Age, Adult, Human, Elderly, Upper limb, Thoracic girdle, Diseases of the osteoarticular system, Trauma, Juxtaarticular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0248626
Code Inist : 002B16H. Création : 11/09/1998.