Purpose
For non-traumatic instability of the shoulder, we performed inferior capsular shift(ICS) according to the main direction of instability and added a glenoid osteotomy(GO) for dysplasia or retroversion of the glenoid. The purpose of this study is to evaluate the results of our operative intervention.
Materials and Methods
We evaluated 16 shoulders(14 cases),5 of which were male and 11 female, three shoulders were habitual subluxation(HA) and 13 shoulders inferior and multidirectional instabiliry(I&MDI). The average age at operation was 16.1 years and the average follow-up period was 31.4 months. ICS(anterior approach) was performed on 9 shoulders, ICS(posterior approach) on 2 shoulders, GO and ICS(posterior approach) on 4 shoulders, and GO and ICS(simultaneous anterior and posterior approach) on 1 shoulder.
Results
The results for 3 shoulders with HS and 9 shoulders with I&MDI, which were mainly 2directional(inferior and anterior or posterior), were good. However the results for 4 shoulders, which had severe three-directional instability, were less favorable except for 1 shoulder on which a simultaneous anterior and posterior approach had been used. In these patients, slipping persisted in a shoulder subjected to the anterior approach, and inferior instability in one subjected to the posterior approach.
Conclusion
Either the anterior or posterior approach is roughly adequate for one or two directional instability. The degree of instability in three-directional instability is more severe than that in one or two diredctional. Stabilization using a simultaneous anterior and posterior approach for severe three directional instability might not be sufficient, but more preferable than that using either an anterior or posterior approach, because of its residual symptoms.
