反復性肩関節前方亜脱臼に対するBristow変法の遠隔成績

抄録

Seven cases in which the modified Bristow procedure was performed for recurrent anterior subluxation of the shoulder were reviewed. The purpose of this study is to present the long-term results of these procedures.
MATERIALS AND METHODS
Seven out of eig h t patients, who underwent the modified Bristow procedure for recurrent anterior subluxation between 1970 and 1980, were able to return for evaluation. Three patients were men and 4 were women. The right shoulder was operated on in 5 patients and the left shoulder in 2 patients. The average age at the time of surgery was 21 yerars and 9 months with a range of 16to 25 years. Three patients had no specific traumatic episode and were engaged in sports activity, such as tennis or volleyball.
Five out of seven patients had only anterior instability, but the others had anterior and inferior instability, or so-called loose shoulder. All patients were treated with a modified Bristow procedure that consisted of fixing the bone block with a screw.
RESULTS
Follow-up time of seven patients averaged 124 months ranging from 60 to 190 months. All patients have not had the so-called dead-arm syndrome after surgery. None of these patients had a positive anterior apprehension test, but one patient who had had anterior and inferior instability had a positive inferior apprehension test. There were no pain in sports or work in 5 patients.
Three patients had a limitation in the range of motion of external rotation, which was 19° with the range from 15 to 22°. Five patients had no limitation in sports or overhead work. The results were: four, excellent; two, good; and one, fair. Five patients were satisfied with the result subjectively,
CONCLUSION
A modified Bristow procedure, which is easily done by the anterior axillary spproach, has the effectiveness in preventing recurrent anterior subluxation in our study.