Abstract
In 1978, we reported the results of the Putti-Platt operation for 88 shoulders with recurrent anterior dislocation. One of the conclusions was that excessive “double-breasting” for the patients with large bone defects of the glenoid should be avoided because of the postoperative restriction of external rotation. According to this conclusion, we have devised combined procedure of the glenoplasty and the Putti-Platt operation. In this study, short-term results and operative details were discussed. From 1981 to 1985, this procedure has been performed on five shoulders of four cases. All the cases involved male subjects. An average age of the patients at the time of operation was twenty three years. Deltopectral approach was used. Close by the articular surface, anterior part of the glenoid neck was osteotomized intra-capsullary on the sagital plane and tilted posteriory with bone chisel. Then, iliac bone was wedged in a gap parallel to the articular surface as outer surface of the iliac crest making a new glenoid cavity. Finally, anterior capsule and subscapularis was doublebreasted same way as the Putti-Platt operaation. Post-operatively, no recurrence was occured and grafted iliac bone was united within 8 weeks. Averages of range of active motion were 158° of flexion,173° of abduction and 81° of external rotation in abduction at the time of follow-up. In three cases, CT with double contrast arthrogram showed newly formed glenoid rims and articular surfaces which were covred by soft tissue with same density as cartilage. Congruency of the newly formed glenoid was good in three shoulders followed 1 year or more.
