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Non-operative treatment of multidirectional shoulder instability

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Abstract.

At an average follow-up of 3.7 years we assessed the results of non-operative treatment of 84 symptomatic shoulders in 59 patients with a diagnosis of multidirectional shoulder instability. Sixty-two shoulders had received no previous surgical treatment (group A) while 22 had failed to respond to surgical treatment before the rehabilitation programme (group B).

Subjectively 11 of the non-operated shoulders (group A) were cured and 27 improved, 23 of the shoulders remained the same and one was worse at follow-up. According to the age and gender adjusted Constant score, 38 of the non-operated shoulders had either no disability or only mild disability, nine had moderate disability, while the remaining 15 had severe or total disability. These figures were far worse in group B. In group A only four shoulders required operation, while in group B seven required operation following rehabilitation.

Patients who had had previous shoulder surgery, those with a work related injury and those with psychological problems were less likely to benefit from the rehabilitation programme.

Résume.

Nous avons suivi pendant 3.7 ans 84 épaules chez 59 patients avec une instabilité multidirectionnelle traitée par un programme de rééducation. Soixante-deux épaules (groupe A) ne recevaient aucun traitement chirurgical, et 22 épaules (groupe B) ont eu un traitement chirurgical inefficace avant la rééducation. Dans le groupe A, 11 sont sans symptôme, 27 sont améliorés, 23 restent sans changement, et une est aggravé. Selon le score de Constant, 38 épaules n'avaient aucune insuffisance ou avaient des signes cliniques très modérés, neuf avaient des signes modérés et 15 avaient une instabilité sérieuse. Les résultats dans le groupe B ont été beaucoup plus mauvais. Dans groupe A quatre épaules et dans le groupe B sept épaules ont été opérées après la rééducation. Les patientes qui étaient traités chirurgicalement á cause d'un accident du travail ont fait leur programme de rééducation avec moins de succès.

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Kiss, J., Damrel, D., Mackie, A. et al. Non-operative treatment of multidirectional shoulder instability. International Orthopaedics (SICOT) 24, 354–357 (2001). https://doi.org/10.1007/s002640000202

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  • DOI: https://doi.org/10.1007/s002640000202

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