[Traumatic shoulder dislocation in young athletes--open or arthroscopic stabilization?].

In case of younger patients up to the 30th year with high sports and professional shoulder stress unacceptable recurrence rates up to 49% following arthroscopic stabilization were published. For these patients we recommend open stabilization also in case of primary dislocation. To evaluate our own results following open stabilization with suture-anchors and capsular shift we examined 15 patients with traumatic anterior shoulder dislocation treated between 1.1.1994-31.12.1997 in our clinic retrospectively. Because of the known prognosis factors all patients were classified as high-risk for recurrence. We could examine all patients after an average follow-up of 2.5 years. At the time of reexamination 10 patients had the same level of sports activities as preoperatively. Most patients demonstrated loss of external rotation up to 10 degrees. Compared with the contralateral shoulder 10 patients demonstrated no loss of muscle power. At one patient recurrence without adequate trauma was observed. All other patients demonstrated no clinical symptoms of instability. According to the criteria of the Constant-Score 13 patients achieved excellent or good results. Therefore we recommend open stabilization for young and sporting patients because of the guarantee of a low recurrence rate due to high levels of sports activities. In our opinion in these circumstances arthroscopy is mainly seen as a diagnostic method to evaluate the shoulder pathology before arthrotomy at the same time.