Shoulder posterior subluxation.

The records of 21 patients with chronic recurrent posterior subluxation were reviewed to document postoperative stability and level of athletic participation after opening wedge posterior scapular osteotomy and associated soft tissue procedures. At an average of 39.9 months after surgery, we objectively reevaluated 17 males and 2 females (from 16 to 46 years old). Patients with posterior instability caused by a direct trauma stabilized and effectively returned to athletic participation following osteotomy. Patients with posterior stability resulting from muscular contraction required additional soft tissue procedures for stability and effective return to athletics. Congenitally or habitually lax shoulders did not stabilize in this series. This study suggests that opening osteotomy is indicated for single plane, posterior instability which results from direct trauma or muscular contraction, and for combined anterior-posterior instability. Opening osteotomy is contraindicated in congenitally or habitually lax shoulders. A descriptive classification system which groups shoulders according to injury force and direction of instability facilitates preoperative prediction of subsequent glenohumeral joint stability and athletic participation or level of nonsportive activity.