Primary anterior dislocation glenohumeral joint adolescence

The natural history of primary anterior dislocation of the glenohumeral joint in adolescent
patients remains unclear and there is no consensus for management of these patients.
The objectives of this study were to report the natural history of primary anterior
dislocation of the glenohumeral joint in adolescent patients and to identify the risk factors
for recurrent dislocation.
We reviewed prospectively-collected clinical and radiological data on 133 adolescent
patients diagnosed with a primary anterior dislocation of the glenohumeral joint who had
been managed non-operatively at our hospital between 1996 and 2008. There were 115 male
(86.5%) and 18 female patients (13.5%) with a mean age of 16.3 years (13 to 18) and a mean
follow-up of 95.2 months (1 to 215).
During follow-up, 102 (absolute incidence of 76.7%) patients had a recurrent dislocation.
The median interval between primary and recurrent dislocation was ten months (95% CI 7.4 to
12.6). Applying survival analysis the likelihood of having a stable shoulder one year after the
initial injury was 59% (95% CI 51.2 to 66.8), 38% (95% CI 30.2 to 45.8%) after two years, 21%
(95% CI 13.2 to 28.8) after five years, and 7% (95% CI 1.1 to 12.9) after ten years. Neither age
nor gender significantly predicted recurrent dislocation during follow-up.

We conclude that adolescent patients with a primary anterior dislocation of the
glenohumeral joint have a high rate of recurrent dislocation, which usually occurs within
two years of their initial injury: these patients should be considered for early operative
stabilisation.