Prosthetic replacement for chronic unreduced dislocations of the shoulder.

Seven patients with chronic dislocations of the shoulder were treated by humeral head or total shoulder replacement. All patients had significant humeral head damage. Three dislocations were posterior and four were anterior. All had been unreduced for at least two months. A Neer prosthesis was used in each patient and the version of the humeral component was altered by 30 degrees-50 degrees away from the direction of the dislocation. Only a sling and swathe was used postoperatively, and the patient was allowed early motion in a limited-goals physical therapy program. There were no redislocations and all patients were improved over their preoperative status. Five patients achieved a good result and two had a fair result based on a 100-unit rating system. One transient axillary nerve palsy occurred, but there were no other complications. Prosthetic replacement for chronic unreduced shoulder dislocations is a reliable procedure when severe humeral head damage exists.