Middle Term Clinical Results of the Modified Bristow Procedure
-Diagnostic Significance of 3D-CT Image with ABER Position-

Abstract

Purpose: The modified Bristow procedure is thought to be suitable surgical method for the treatment of recurrent dislocation in collision athletes. Abduction and external rotation (ABER) position is useful for the evaluation of Bankart lesion and 3D-CT image is useful for evaluating bony morphologies. The aim of this study was to evaluate middle term clinical results of the modified Bristow procedure in collision athletes with reference to ABER 3D-CT imaging. Methods: We evaluated 15 shoulders treated with the modified Bristow procedure. The average age at operation was 28.7 years old. The average follow-up was 62.4 months. Clinical results were evaluated with Rowe scoring system. Range of motions of external rotation at 90 degree of abduction in the affected shoulders were measured and compared with those in the non-affected shoulders. 3D-CT images were obtained in the ABER position. Bony state between the transferred coracoid and glenoid was evaluated by the glenoid cavity images; shoulder joint stability was analyzed by the anterior-posterior images. Result: Re-dislocation was observed in 0%. However, subluxation was observed in 6.7%. The average Rowe score was 94.0 points in total. Average range of motion of external rotation was 96.6 degrees in the affected shoulders and 107.6 degrees in non-affected shoulders. 3D-CT images in ABER position revealed humeral head subluxation and displaced coracoid non-union combined with screw breakage in a clinically failure case. Conclusion: Middle term clinical results of the modified Bristow procedure were relatively acceptable. 3D-CT images in ABER were useful for the evaluation of postoperative joint stability.