Anterior dislocation of the shoulder in elderly patients

Of 545 consecutive patients with anterior shoulder dislocations, 108 (20%) were aged 60 years or more at the time of injury, We reviewed and radiographed 95 of these elderly patients after a mean follow-up of 7.1 years, Axillary nerve injuries were seen in 9.3% of the 108 patients, but all recovered completely in 3 to 12 months, There were single or multiple recurrences of dislocation in 21 patients (22.1%), but within this group age had no influence on the tendency to redislocate. Tears of the rotator-cuff were diagnosed by imaging studies or clinically in 58 patients (61%), including all who had redislocations, Sixteen patients required surgery, Eight with a single dislocation and a cuff tear had only repair of the torn cuff, Of the eight patients with multiple dislocations requiring operation, five also had a torn cuff and needed either a stabilising procedure and a cuff repair or repair of the cuff only, All patients who were operated on had a satisfactory result, with the exception of those with multiple redislocations and a cuff tear who had repair of the cuff only. Anterior shoulder dislocation in elderly subjects is more common than is generally believed; 20% suffer redislocation and 60% have a cuff tear, Operation may be needed to repair a torn cuff or to stabilise the shoulder, Patients with multiple redislocations will probably require both procedures.