A SURGICAL PROCEDURE FOR REPAIR OF RECURRENT DISLOCATION OF THE SHOULDER JOINT

A Preliminary Report

¹ Medical Corps, United States Naval Reserve

Operations were performed in thirty-two cases,—thirty men and two women. Their ages ranged between eighteen years and thirty-four years. Twelve dislocations occurred in the right shoulder; sixteen occurred in the left shoulder; and two were bilateral. In eight cases the first dislocation occurred during combat fighting, in thirteen while engaged in athletics, in seven from a fall, and in one while rolling a barrel; in three cases the cause was not remembered. The treatment after the first dislocation varied: No treatnment was given in fifteen cases, a sling was used for less than three weeks in twelve cases and for three weeks or more in four cases, and treatment was not remembered in one case. Preoperative examination of the shoulder showed limited and painful motion in thirteen cases, muscle atrophy about the shoulder in three, and subluxation of the joint in ten; all had deep tenderness over the front of the shoulder joint. Roentgenographic findings were negative in twenty-four cases, showed subluxation in three, calcium deposits in the subdeltoid bursa in one, a shallow glenoid fossa in one, a groove in the head of the humerus in one, roughness of the anterior glenoid rim in one, and roughness in the greater tuberosity and acromion in one.

All of the operations except one were done on Marine personnel. Eight cases have been followed for more than one year; the remaining cases have been followed for more than six months. In one case in the series, the operation failed, because the new attachment of the tendon pulled away from the acromion when time patient threw a football, four weeks after operation. In twenty-seven of the remaining thirty cases, the patients returned to full combat duty. The other three patients could not return to full duty, although the shoulder was stable. Follow-up letters have been received from two of the three patients, stating that they are doing heavy work without discomfort. In the remaining case there has been no further dislocation, and a follow-up letter from the patient's mother states that he does not want to work.

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