Shoulder posterior subluxation

Abstract

The records of 21 patients with chronic recurrent pos terior subluxation were reviewed to document postop erative stability and level of athletic participation after opening wedge posterior scapular osteotomy and as sociated soft tissue procedures. At an average of 39.9 months after surgery, we objectively reevaluated 17 males and 2 females (from 16 to 46 years old). Patients with posterior instability caused by a direct trauma stabilized and effectively returned to athletic participa tion following osteotomy. Patients with posterior stabil ity resulting from muscular contraction required addi tional soft tissue procedures for stability and effective return to athletics. Congenitally or habitually lax shoul ders did not stabilize in this series. This study suggests that opening osteotomy is indi cated for single plane, posterior instability which results from direct trauma or muscular contraction, and for combined anterior-posterior instability. Opening oste otomy is contraindicated in congenitally or habitually lax shoulders. A descriptive classification system which groups shoulders according to injury force and direction of instability facilitates preoperative prediction of sub sequent glenohumeral joint stability and athletic partic ipation or level of nonsportive activity.