Neglected Anterior Dislocation of Shoulder: is surgery necessary? A Rare Case with review of literature.
BACKGROUND
Shoulder joint is the most frequently dislocated joint. However, it is rarely neglected and treatment is sought immediately. Delayed or neglected shoulder dislocations are difficult to manage and require extensive procedures to obtain good functional outcome. Very few cases are described in literature showing neglected shoulder dislocation with good functional range of movement. We report a case with 3 years of neglected anterior shoulder dislocation with preserved joint function.


METHODS
A 40 years old gentleman presented withfracture distal end of the radius (left). On clinical examination we observed that he had anterior dislocation of his left shoulder which was confirmed on radiographic evaluation. He had history of seizures 3 years back, which may be the cause of dislocation which went unnoticed. On examination he had good range of motion without any pain. Patient could perform all routine activities with no major functional limitation. At three years after dislocation CT Scan showed neocavity formation.


CONCLUSIONS
Neglected shoulder dislocation with preserved joint function without major functional limitation is a rare presentation. This condition should be kept in mind in patients with history of seizures. Proper evaluation and counseling of patients avoids extensive procedures and avoids complications of surgery. Observation can be a treatment option in patients with preserved range of movement especially involving non dominant handand having low functional demand. This report presents rare presentation of neglected shoulder dislocation highlighting its natural history and its outcome following conservative treatment.
Department of Orthopaedics, R.n.cooper Municipal General Hospital, Bhaktivedanta Swami Marg, Juhu, Mumbai 400056.
Kunal
K
Shah
Department of Orthopaedics, R.n.cooper Municipal General Hospital, Bhaktivedanta Swami Marg, Juhu, Mumbai 400056.
Tushar
T
Ubale
Department of Orthopaedics, R.n.cooper Municipal General Hospital, Bhaktivedanta Swami Marg, Juhu, Mumbai 400056.
Harish
H
Ugrappa
Department of Orthopaedics, R.n.cooper Municipal General Hospital, Bhaktivedanta Swami Marg, Juhu, Mumbai 400056.
Samir
S
Pilankar
Department of Orthopaedics, R.n.cooper Municipal General Hospital, Bhaktivedanta Swami Marg, Juhu, Mumbai 400056.
Atul
A
Bhaskar
Department of Orthopaedics, R.n.cooper Municipal General Hospital, Bhaktivedanta Swami Marg, Juhu, Mumbai 400056.
Satishchandra
S
Kale
Anterior Dislocation; Neglected; Preserved Joint Function