MEHMET OZBEY BUYUKKUSCU, AHMET KULDUK, ABDURRAHMAN AYDIN, ENGİN ÇETİNKAYA, ŞÜKRÜ SARPER GÜRSÜ
Anatolian Current Medical Journal - 2021;3(2):140-144
Objective: To investigate the factors affecting the recurrence of anterior shoulder dislocation, identify the patient group with the highest recurrence rates of shoulder dislocation, and determine the patient population to be recommended surgical treatment after the primary dislocation. Materials and Method: We retrospectively screened the patients diagnosed with a primary shoulder dislocation and treated in our hospital between January 2005 and January 2017. Of the 1395 patients identified, we reached 1253 over phone calls to obtain follow-up information. The study excluded patients with no follow-up information, those with posterior dislocations, multidirectional instabilities, general joint hypermobility, traumatic nerve injury or shoulder fracture-dislocations (including greater tuberosity and glenoid fractures), and surgical treatment after a primary dislocation. We evaluated the general joint laxity of the patients using the Beighton scale. We recruited patients with a traumatic primary anterior shoulder dislocation and at least two years of follow-up data and divided them into three age groups: under 20 years, 20 to 40 years, and over 40 years. Results: After applying the exclusion and inclusion criteria, 1,004 patients were included in the study. We detected recurrence in 408 patients (40.6%). The group under 20 years had the highest recurrence rate with 52% (88/170). We determined the recurrence rates as 43% (283/659) in the group aged 20-40 years and 21% (37/175) in the group over 40 years, respectively. However, except for age, we reached gender, presence of bone defects (Hill-Sachs lesion), and remaining parameters (immobilization time, injury mechanism, exercise habits and type of sports activity, dominant-side dislocation, and smoking) had no significant impact on the risk of recurrence after a primary dislocation. Conclusion: The surgical treatment option should be presented to young male patients with bone defects after a primary dislocation. They also need to be informed about the possible difficulties due to recurrent instability.
