<![CDATA[Old unreduced anterior shoulder dislocation (OUAD), defined as a dislocation unreduced for at least three weeks, is technically demanding because capsulolabral injury, glenoid bone loss, Hill-Sachs lesions, and capsular contracture may coexist. Open reduction with temporary K-wire fixation preserves the humeral head but does not reconstruct glenoid deficiency, while the Latarjet procedure provides an anterior bone block and sling effect. Objective to compare six-month functional outcomes after open reduction with temporary Kirschner-wire (K-wire) fixation and early Latarjet procedure in patients with old unreduced anterior shoulder dislocation (OUAD). This retrospective cohort included 34 adults with OUAD treated surgically between January 2022 and December 2025. Eighteen underwent open reduction with temporary K-wire fixation and 16 underwent early Latarjet stabilization. The primary outcome was the Constant-Murley Score (CMS) at six months. Baseline variables were compared using independent-samples tests or Fisher's exact test as appropriate; CMS subdomains were compared non-parametrically when distributional assumptions were not met. Mean age was 47.29 ± 16.96 years, and 21 patients (61.8%) were women. Dislocation duration was longer in the K-wire group than in the Latarjet group (19.83 ± 5.81 vs. 9.75 ± 6.10 weeks; P < 0.001), whereas glenoid bone loss >25% was more frequent in the Latarjet group (P = 0.003). Total CMS was comparable between groups (58.61 ± 11.09 vs. 60.93 ± 9.28; P = 0.515). The K-wire group had higher pain-domain scores, whereas the Latarjet group had higher activities-of-daily-living and range-of-motion scores. Motor strength was similar. At six months, temporary K-wire fixation and early Latarjet produced comparable total CMS in selected patients with OUAD, but the domain-level recovery profiles differed. These findings should be interpreted in light of baseline treatment-selection differences and the retrospective design.]]>
