抄録
There has been no difinitive treatment for habitual posterior dislocation of the shoulder. The purpose of this study was to evaluate the clinical results of the glenoid osteotomy combined with the posterior capsulorrhaphy for patients with habitual posterior dislocation of the shoulder. There were 5 men and 3 women with an average age at operation of 21 years(range,15-45 years), totally eight shoulders in 8 patients. All of the patients had a positive sulcus sign indicating an inferior looseness in addition remarkable posterior instability. The patients who had remarkable anterior instability(loose shoulder)and could dislocate their shoulders voluntarily were excluded from this study.
An osteotomy was performed so that the atticular surface of the glenoid inclined both anteriorly and superiorly. A bone block taken from the iliac crest, was trimmed to be about 20°wedge-shaped and to extend to the posterior edge of the glenoid and was used for all the patients. The mean follow-up period after surgery was 4.5 years(range,1.4-9.8 years)
Two patients did not improve their posterior instability postoperatively, one had a general joint laxity and the other had an insufficient corrective angle of the glenoid by osteotomy. The other six patients improved their posterior instability and were satisfied with the results. A subacromial impingement occured in one but was successfully managed with an arthroscopic subacromial decompression. So, patient selection and proper surgical techniques seem to be the key factors for successful results.
In conclusion, a glenoid osteotomy combined with posterior capsulorrhaphy was effective for habitual posterior dislocation of the shoulders.
