高齢者の反復性肩関節前方脱臼の2例

抄録

Recurrent anterior dislocation of the shoulder generally occurs in youths, and is rarely seen in the aged. Here we present two cases of recurrent anterior dislocation of the shoulder in the aged.
Case 1. A 79-year-old female fell and dislocated her right shoulder for the first time. Despite adequate manual reduction and splinting for four weeks, recurrent dislocation has occurred several times since then. CT demonstrated anterior subluxation with a posterolateral notch. Surgical treatment was performed using the modified Bristow procedure, and subscapularis has disappeared. She has had no dislocation since surgery.
Case 2. An 84-year-old female fell and dislocated her right shoulder for the first time. Since then, recurrent dislocations have occurred easily. CT and MRI revealed a posterolateral notch. The modified Bristow procedure was performed. She has had no dislocation, and has had a stable mobile shoulder since surgery.
Weakness of the anterior elements including subscapularis in Case 1, and enlargement of the posterolateral notch due to osteoporosis in Case 2 should be considered as a leading cause of recurrent anterior dislocation. Conservative treatment was not effective, and surgical treatment was indicated to prevent recurrent dislocation and to regain the range of motion of the shoulder for daily life activities.