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Intermediate Outcomes After Primary Traumatic Anterior Shoulder Dislocation in Skeletally Immature Patients Aged 10 to 13 Years
Cordischi K, Li X, Busconi B. Intermediate outcomes after primary traumatic anterior shoulder dislocation in skeletally immature adolescents aged 10 to 13 years. Orthopedics. 2009 Sep;32(9): 646-52.
A paucity of literature exists regarding the outcome of skeletally immature patients who sustain a primary traumatic anterior shoulder dislocation. Most published results focus on adolescents and young adults, using recurrent dislocation/instability as a determinant of outcome, rather than a validated quality of life measurement tool. The purpose of this study is to assess the intermediate term functional outcome after anterior traumatic shoulder dislocation in the skeletally immature patient population. Fourteen patients (age range, 10.9-13.1 years; 14 shoulders) who sustained a primary anterior traumatic unidirectional shoulder dislocation were included. Each patient underwent successful documented closed reduction of the dislocated shoulder and was subsequently treated with initial nonsurgical intervention. All patients were monitored in the clinic routinely, until skeletal maturity was reached. The Western Ontario Shoulder Instability index (WOSI), range of motion, complications, and recurrent dislocations were recorded. The average WOSI score for all patients at the time of injury was 1635 (range, 1550-1690). At final follow-up (mean, 5.6 years), the average WOSI score for all patients was 39.6 (range, 0-195). Subgroup analysis revealed that those treated nonoperatively fared better than their operative counterparts (average final follow-up WOSI score, 9.1 vs 151.7, respectively). Three patients (21.4%) ultimately sustained a recurrent shoulder dislocation that necessitated surgical intervention. Based on the above data, in the pediatric skeletally immature patient who sustained a primary, traumatic, anterior shoulder dislocation, nonoperative treatment results in low shoulder instability recurrence risk and sound functional outcomes.