1999 年 23 巻 3 号 p. 453-456
[Purpose] Recurrent anterior dislocation of the shoulder in elderly patients has seldom been reported, and the pathologic features of this group have not been fully clarified in the literature. The purpose of this study was to report our operative findings and to investigate the etiology of the recurrent anterior dislocation of the shoulder with onset after the age of 50.
[Materials and Methods] We retrospectively studied nine patients who were over 50 years old at the time of initial traumatic dislocation and then who had recurrent instability of the shoulder. We evaluated the operative findings as follows: rotator cuff tear, Bankart lesion, anterior capsular injury. One patient was treated with the Putti-platt method and three had inferior capsular shifts. The other five patients were treated with a Bankart repair. In addition to those operations, seven of them were treated with a modified Bristow method.
[Results] Rotator cuff tears were seen in 5 patients, and four of them were massive tears with a subscapularis rupture. There was an elongation of the subscapularis in the other patient. Bankart lesions were seen in 5 patients with a bony lesion. The other 4 patients had abnormal lesions of the anterior capsule.
[Conclu sion] In elderly patients, destruction of the shoulder anterior stability structure including the sabscapularis should be considered as one of the main causes of recurrent anterior dislocations.