This study retrospectively reviewed the pathology after the first traumatic incident of shoulder subluxation or dislocation in 12 male and four female patients with a mean age of 14.9 years (12 to 16). All had undergone surgery and were seen over a five-year period. Patients seen after a second traumatic dislocation were excluded.

All patients had been treated conservatively for between 4 and 18 months. When conservative treatment failed, all patients underwent examination and shoulder arthroscopy. All 16 had Hill-Sachs lesions of varying degrees. Bankart repairs were done in 14 patients with Bankart lesions. Two patients had more than 25% bone loss of the glenoid, and Latarjet procedures were undertaken. One SLAP-III and three SLAP-II repairs were done. The follow-up period varied from three months to five years.

All patients were either examined or interviewed by telephone. Failures were defined as recurrence of symptoms or redislocations. All patients resumed their sporting activities at similar or higher levels. Two patients with multidirectional shoulder laxity had further possible subluxations but were treated conservatively. One sustained a massive bony Bankart lesion a year after a Bankart repair and a Latarjet procedure was subsequently performed.

Patients in this age group should be considered at high risk for recurrence. If intensive short-term rehabilitation fails, they should be managed surgically immediately.