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Recurrent subluxation of the glenohumeral joint

Department of Orthopaedics, The Wellesley Hospital, Toronto, Ontario

Larry P. Coughlin, MD

Department of Orthopaedics, The Wellesley Hospital, Toronto, Ontario

Recurrent subluxation of the shoulder is a common condition. In our hospital, 30% of operations for shoul der instability were performed on patients who never had a frank dislocation but presented with symptoms of instability or, occasionally, simply with pain on throwing. The most common physical finding in this group was apprehension on abduction-external rota tion. Thirty-four of the 50 shoulders with subluxation showed radiological changes consisting mainly of in fraglenoid new bone formation. Six showed fracture of the anterior glenoid margin. Examination under anaesthesia demonstrated the instability on all cases in which it was tested. Thirty-three of the 50 shoulders had Bankart lesions and six had anterior glenoid mar gin fractures. Thirty-nine shoulders were treated by Putti-Platt repair and 10 had stapling alone. There was a tendency for loss of external rotation in patients with Putti-Platt reinforcement. We conclude that re current subluxation of the shoulder is a common injury that can be confirmed by demonstrating subluxation under anaesthesia, and Bankart repair alone is rec ommended if the athlete is to return to throwing activ ities.

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