Restricted accessCase reportFirst published online 2012-10
Physiotherapy and Botulinum Toxin Injections Prior to Stabilization Surgery for Recurrent Atraumatic Anteroinferior Shoulder Dislocation with Abnormal Muscle Patterning
Shoulder instability is a complex phenomenon and repeated dislocation due to persistent abnormal muscle patterning can be challenging to manage. This case report describes the treatment of a 21-year old female who presented with repeated atraumatic anteroinferior shoulder dislocation due to abnormal muscle patterning. Management involved physiotherapy to re-educate muscle control combined with botulinum toxin injections into pectoralis major, latissimus dorsi and teres major prior to shoulder stabilization surgery. The patient reported marked improvement as reflected by improved scores on the Oxford Shoulder Instability Score and Western Ontario Shoulder Instability Score. Benefits were maintained at 3 year follow-up.
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