Medical Journal of The Islamic Republic of Iran (MJIRI)

    Background: Chronic anterior shoulder dislocation is an uncommon but challenging condition, in which reduction may be associated with significant neurovascular problems. The Latarjet procedure has been widely recognized as an effective surgical option for recurrent shoulder instability. This study aimed to evaluate the vascular complications of chronic anterior shoulder dislocation treated with the Latarjet procedure.
   Methods: This retrospective cohort study included 19 patients (21 shoulders) with chronic anterior shoulder dislocation treated with open reduction and the Latarjet procedure. The patients with chronic dislocation more than 4 weeks and less than 1 year included. All procedures were performed via a deltopectoral approach with coracoid osteotomy. Demographic data, postoperative shoulder range of motion (ROM), the visual analogue scale (VAS), and functional outcomes assessed by the American Shoulder and Elbow Surgeons (ASES) score and Oxford Shoulder Score (OSS) were collected. The patients were followed for a minimum of 9 months. Continuous variables were summarized as mean ±standard deviation and categorical variables as frequencies and percentages; given the absence of a control group and the small sample size, only descriptive statistics were performed (STATA version 17).
   Results: The mean age of patients was 30.89 ± 11.88 years, and 16 patients (84.21%) were male. The mean duration from injury to surgery was 7.09± 2.66 weeks, with a mean follow-up period of 9.11± 4.30 months. No intraoperative vascular or neurological complications were observed. Coracoid graft union, confirmed radiographically, was achieved in all 21 patients (100%). The mean VAS pain score was 1.76 ± 1.04. Functional outcomes showed a mean ASES score of 72.14 ± 11.58 and OSS of 26.71 ± 6.41. Passive range of motion included forward flexion of 130.23° ± 31.79°, abduction of 116.66° ± 39.15°, and external rotation of 48.33° ± 23.73°.
   Conclusion: Chronic anterior shoulder dislocation is a technically challenging condition associated with bone loss, potential neurovascular complications, capsular adhesion, and contractures. It is observed that open reduction and Latarjet procedure can be associated with satisfactory shoulder range of motion, coracoid graft union, and no recurrent dislocation or neurovascular complications.