Treatment of chronic anterior shoulder dislocations (literature review)

Abstract

Background. Long–standing anterior shoulder dislocations account for 23.7-25% of all shoulder dislocations. If we take the data of A.L. Tolstykh and A. Mohamad (2013), the incidence of long-standing dislocations is 23%. In our opinion, the presented data are presented with a certain subjectivity and do not fully reflect the clinical reality. After analyzing the studies, the frequency ranges from 0.10% to 0.18%, and elderly patients are most susceptible due to degeneration of the rotator cuff muscles. The causes of long-standing dislocations include untimely medical treatment, which is often associated with the low social status of patients, attempts to correct dislocation on their own or with the help of people without proper medical education, insufficient diagnosis of dislocations in rural areas, diagnostic errors against the background of the workload of the trauma center, epilepsy. Accordingly, the probability of successful reduction under general anesthesia is low, due to the development of scar tissue and the formation of joint contracture. The purpose of the study is to analyze the literature data and provide an overview of views on the treatment of longstanding anterior shoulder dislocations. Materials and methods. The review includes publications covering the period from 1770 to 2025. The earliest work, dated 1770, is considered as a historical source, while the main analysis is based on articles published since 1960. The search and analysis of foreign and domestic literature were conducted using the online resources eLibrary, CyberLeninka, PubMed, ResearchGate, Elsevier, Scopus, Web of Science, Cochrane Library. Results. Currently, there is very little modern literature devoted to the treatment of long-standing anterior shoulder dislocations. Various variants of open reduction have been proposed, most of which are technically difficult and have unsatisfactory results. In foreign literature, it is proposed to perform reversible arthroplasty in elderly patients, regardless of the period of dislocation. In young patients, joint-saving operations are followed. The installation of an endoprosthesis in young people will inevitably lead to the need for revision interventions. Conclusion. Good functional results in people with longstanding shoulder dislocation are observed when performing reversible arthroplasty. There are certain concerns about performing endoprosthetics in young and middle-aged people. The results of open joint reduction and stabilization often lead to unsatisfactory functional outcomes. Therefore, the search for the most effective ways to treat this pathology is relevant and requires further study.