The Clinical Results of a Bankart & modified Bristow Procedure for a Recurrent Anterior Dislocation of the Shoulder

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  • 反復性肩関節前方脱臼に対するBankart法&Bristow変法合併手術の臨床成績

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Abstract

To clarify the clinical efficacy of a Bankart & modified Bristow procedure for a recurrent anterior dislocation of the shoulder. Materials and methods: 120 shoulders with recurrent anterior dislocation who had recieved a Bankart & modified Bristow procedure were investigated. They were able to be observed for more than two years postoperatively. There were 94 men and 26 women, and the mean age at operation was 25 years (range,14-69). The mean follow up period was 41 months (range,24-75). The operation was done according to a Bankart's procedure augmented by a coracoid transfer (modified Bristow technique). Postoperative immobilization was maintained in a Velpeau position for 3 weeks, after that, ROM excercises were started. Normal daily activity was allowed after 2 months. A return to athletic activity was allowed at 3 months, and to contact sports at 6 months. We evaluated the clinical results by the Rowe scoring system, the return to sports activity, satisfaction with the operations, and the complications. Results: According to the Rowe scoring system, the clinical results were graded as excellent for 76%, good for 13%, fair for 11%, and poor for 0%, with an average score of 90 points. There was no redislocation postoperatively, but subluxation was seen in 2 cases(1.6%). The average loss of range of motion compared with the opposite side was 13° for external rotation.93% of the athletes could return to their previous sports and 53% could return to their preinjury levels. The complication seen in this series consisted of only one screw breakage. No one had osteoarthritic change of the glenohumeral joints. Discussion: With our method, repair of the main lesion of the IGHL complex and a buttress effect by the conjoined tendon in abduction seemed to secure a strong stability. This procedure can achieve a good clinical outcome for high level athletes with recurrent anterior dislocation of the shoulder.

Journal

  • Katakansetsu

    Katakansetsu 24 (3), 413-416, 2000

    Japan Shoulder Society

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