In thirty-six patients (forty shoulders) with involuntary inferior and
multidirectional subluxation and dislocation, there had been failure of
standard operations or uncertainty regarding diagnosis or treatment.
Clinical evaluation of these patients stressed meticulous psychiatric
appraisal, conservative treatment, and repeated examination of the
shoulder. All patients were treated by an inferior capsular shift, a
procedure in which a flap of the capsule reinforced by overlying tendon is
shifted to reduce capsular and ligamentous redundancy on all three sides.
This technique offers the advantage of correcting multidirectional
instability through one incision without damage to the articular surface.
One shoulder began subluxating again within seven months after operation,
but there have been no other unsatisfactory results to date. Seventeen
shoulders were followed for more than two years.