Conservative treatment following primary shoulder dislocation?

Between January 1989 and March 1997, 175 patients with traumatic shoulder dislocations were treated by conservative means (median age 41 years, 39 F, 136 M). In 78 patients (17 F, 61 M) a clinical and radiological follow up (median 50 months, range 6-106) could be obtained. Additionally, a diagnostic ultrasound was carried out in all patients. The recurrence rate in the group younger than 30 years (G < 30; n = 35) was 86 %; in the group older than 30 years (G > 30; n = 43) it was 21% (P < 0.05). Persisting neurological deficits were found in 6 patients (8 %). According to the Rowe score, 16 patients (46 %) of the G < 30 achieved excellent or good results, in the G > 30, 29 patients (67 %). In 17 % of cases, a glenohumeral arthrosis was diagnosed be radiological means. 18 % had radiological signs of a previous fracture of the greater tuberosity. Hill-Sachs lesions were identified in 19 % of cases. Rotator cuff tears were diagnosed in 9 % by ultrasound. No relationship between the duration of immobilization and the recurrence rate was found (P = 0.95). The recurrence rate following primary shoulder dislocation depends primarily on the patients' age.