Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report

Abstract

Inferior/multidirectional instability of the shoulder is a complex condition, which is diffi cult to diagnose and manage, and there is no good evidence regarding treatment. A case series of 40 shoulders (36 patients) with inferior/multidirectional instability of the shoulder referred to the author is presented. Instability was found to be due to inherent laxity of the shoulder capsule or due to repetitive overhead activities. Patients were evaluated clinically by examination, stress and apprehension tests, traction radiographs and further examination at the time of surgery. Arthrograms were not found to be benefi cial. Surgery was recommended in patients with disability persisting for more than 1 year not improved by conservative methods to strengthen the rotator cuff. The surgical technique of an inferior capsular shift through an anterior or posterior approach was used for all patients; a satisfactory outcome was seen in all but one patient.