抄録
There have been reported on the clinical results of modified Bristow's operation for the treatment of recurrent dislocation of the shoulder and on the transferred site of the coracoid process. We performed arthroscopy on patients at the removal of the screw, and reviewed the results to give a better understanding of the dislocation-preventing mechanism supplied by a modified Bristow's operation.
The subjects were 15 patients (15 shoulders,12 men and 3 women, age ranging from 17 to 29 years old, mean age 20.8 ) who had reviewed modified Bristow's operation for recurrent dislocation or subluxation of the shoulder at least one year before. Group A patients (10 cases) had received capsulorraphy in addition to modified Bristow's procedure but Group B patients (5 cases) had not. Arthroscopic findings were classified into three types and evaluated according to the capsular repair, the transferred site of the coracoid process, clinical results and objective instability.
Arthroscopic findings included three types; Type 1, the continuity of the articular cartilage and the anterior capsule had recovered; Type 2, the capsule was partly repaired but concavity remained in the anterior rim; Type 3, no repair process was observed. Type 1 was seen in nine out of 10 Group A patients. Type 2 occurred in one Group A patient in whom the coracoid process formed pseudoarthrosis 8 mm medially from the glenoid rim, and also in three Group B patients. Type 3 was observed in one patient in whom the screw had broken off. In Type 2 patients, the transferred site of the coracoid process was 10.3 mm on average from the glenoid rim, significantly longer in comparison to the distance obtained in Type 1 patients,7.7 mm. These results suggested that the existence of a concavity may be closely related to the transferred site of the coracoid process and the repair of the capsule. There should be further evaluations of the correlation of arthroscopic findings and clinical results.
