The Limits of the Ability of Conservative Treatments for Multidirectional Instability of the Shoulder Joint

Abstract

We have reported on the good results obtained from the conservative treatment of multidirectional instability of the shoulder joint. However, there have been a few cases which did not respond to this treatment. In this study, we investigated the limits of the ability of conservative treatment for multidirectional instability of the shoulder joint by comparing those cases which responded with those which did not.
We treated 44 cases (21 cases: male,23 cases: female) with multidirectional instability of the shoulder joint from November 1988 to June 1991. The initial 12 patients were treated using rotator muscular strengthening exercises, mainly. Six cases did not respond and were treated surgically.
The other 32 cases were treated using muscular strengthening exercises and a scapu l ar stabilizing band, and their results were better than those in the initial group. But, four of them had to be treated surgically.
We found a few cases did not respond to the conservative treatment. These unresponded cases had specific clinical features that were as follows.
1) severe rest pain, and numbness and/o r swelling in the hand and forearm,2) severe shoulder joint laxity, and 3) involuntary painful dislocation.
Most of the cases with multidirectiona l instability of he shoulder joint can get well by conservative treatment, but a few cases can not and need surgical treatment.