Anterior dislocation of the shoulder in skeletally immature patients: comparison between non-operative treatment versus open Latarjet's procedure

Authors: Khan A, Samba A, Pereira B, Canavese F

References: Bone Joint J. 2014 Mar;96-B(3):354-9

The ideal treatment for traumatic anterior dislocation of the shoulder in the skeletally immature patient is controversial.
The aim of this study is to evaluate the outcomes after either conservative and/or surgical treatment using the Latarjet technique.
A retrospective series of 49 out of 80 patients were reviewed.
We found no significant differences between either treatment method regarding functional scores and pain levels.
Although not statistically significant, post-surgical patients showed better signs of shoulder stability than others who have a higher rate of recurrence.
Further, 92% of the post-surgical group had returned to the same level of activity versus 52% in the non-surgically treated group.
We found no contraindications to operate on a skeletally immature patient.

Comments (LF):
This paper confirms that skeletally immature patients with a high ISIS score (>6) do well with a Latarjet procedure. It also shows that non-operated patients with a low ISIS score do not do well without surgery. Unfortunately, the two groups are not comparable, so one cannot conclude that skeletally immature patients with traumatic instability do better with a Latarjet, than without surgery!! 


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