Recovery from Primary Shoulder Dislocation and its Complications

Abstract

Out of 226 patients with primary shoulder dislocation followed up for 1 year, 57 (25 per cent) had one or more complications. There were 25 plexus lesions, 19 axillary nerve lesions and 26 rotator cuff ruptures.

The 127 patients over 50 years of age (56 per cent), plus 53 patients under 51 years, were immobilized for 1 week with a mitella. the remaining 46 patients under 51 years were immobilized for 3 weeks.

Recovery was ascertained in terms of the time needed to regain normal mobility of the shoulder, the disappearance of signs of nerve lesions and the length of the sick leave period. A total of 163 (72 per cent) of the patients achieved normal mobility in 3 months, but 42 shoulders (19 per cent) were still not fully mobile after 1 year. the mobilization was significantly retarded by advanced age, long immobilization, long “non-reduced period”, rotator cuff rupture, and a severe primary dislocation. Students and office workers regained normal mobility of the shoulder in a shorter time than manual labourers (P < 0.001) or persons in retirement (P < 0.001), and manual labourers required a longer sick leave period than office workers (P < 0.001). There was no difference regarding recovery from axillary nerve or plexus lesions, but the patients under 51 years with nerve lesions obtained a more complete cure than the older patients (P < 0.05). All patients with complications, (except one patient with a rotator cuff rupture) returned to work during the follow-up period.

Key Words:

• nerve lesions
• recovery of function
• rotator cuff rupture
• shoulder dislocation