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Journal of Bone and Joint Surgery, 1949;31:153-159.
© 1949 by The Journal of Bone and Joint Surgery, Inc

ACUTE ANTERIOR DISLOCATION OF THE SHOULDER

Toufick Nicola M.D.1

1 MONTCLAIR, NEW JERSEY

Perhaps no far-reaching conclusions should be drawn from this small series of twentyseven cases of acute anterior dislocation of the shoulder. However, it seems fair to say that:

1. The pathological findings in acute anterior dislocation of the shoulder are not the same in every case.

2. The injury depends upon the causative force. Hyperabduction will tear the capsule from the neck of the humerus and, if severe enough, will tear part or all of the attachment of the subscapularis tendon away from the humerus. If a force of impaction is added as the arm goes into abduction, the labrum glenoidale and the capsule will tear from the neck of the scapula, also in a longitudinal direction.

3. Reduction of acute anterior dislocations is accomplished with the least amount of trauma by traction and adduction, with the fist high in the axilla.

4. Most recurrent dislocations of the shoulder are the result of too early and too vigorous use of the shoulder, before the capsule has had time to heal and to reattach itself to the neck of the humerus or the neck of the scapula. An eight-week period of immobility in an apparatus which will prevent abduction and external rotation gives the best results.


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