A triple procedure for treatment of traumatic recurrent anterior glenohumeral dislocation

الملخص EN

Objective : Various procedures have been described for the repair of the traumatic recurrent anterior dislocation of the shoulder.

Spontaneous recovery from this common functional disability, particularly in young active individuals, is impossible and surgery is the only sure way of curing these unstable joints.

Methods: Between 1984 and 1999 we repaired ninety-three shoulders with traumatic recurrent anterior dislocation of the shoulder using a triple combined procedure (reattachment of the Bankart lesion, transfer of the coracoid process, and treatment of the capsuloligamentous laxity).

Seventy-seven shoulders were followed for two to fourteen years with an average follow up of 8.6 years.

At follow up, evaluation including history, physical examination and standard shoulder radiographs were done.

Results : Bankart lesion was found in all 77 (100 %) shoulders.

The anterior rim of the glenoid was fractured from one-quarter to one-half of the articular surface in 21 (27.2 %) cases.

Hill-Sachs lesion was present in 49 (63.3 %) cases.

Loose bodies were found in 18 (23.3 %) shoulders.

There were no redislocations or subluxations and four patients had mild apprehension when placing the arm in elevation and external rotation.

Eleven patients had mild discomfort while working with the arm elevated There was limitation of active external rotation from 5-15 degrees in 15 (19.5 %) shoulders, 60 degrees in one patient, and one patient had zero external rotation.

According to the rating scale system ofRowe et al ; 72 (93.5 %) shoulders scored good or excellent, 3 (3.9 %) fair, and 2 (2.6 %) were poor.

Conclusion : This combined procedure is an effective method of treating traumatic recurrent anterior dislocation of the shoulder and it offers excellent results without a single recurrence or complication.