Early complications of acute anterior dislocation of the shoulder in the middle-aged and elderly patient.

Shoulder function following acute anterior dislocation may be impaired by rotator cuff rupture, fracture of the greater tuberosity and/or nerve injury. Twelve such cases seen at a referral shoulder clinic are described. The most common symptoms were loss of movement (100 per cent of patients) and pain (66 per cent). Some loss of active abduction was present in all cases and muscle wasting in 33 per cent. Operation was indicated in 9 patients. There were 2 good, 3 fair and 4 poor results following "late' operation performed as a salvage procedure. Rotator cuff rupture may be obscured by a circumflex nerve palsy. If suspected, diagnosis can be confirmed by careful clinical evaluation, together with arthrography and electromyographic studies. Functional improvement and pain relief were obtained in 4 of the 5 patients who underwent late surgical repair for this complication.