1998 Volume 22 Issue 2 Pages 249-254
We have performed a posterior glenoplasty using an iliac tri-cortical bone graft for recurrent posterior dislocation of the shoulder since 1993. The purpose of this paper is to report on our surgical procedure and the results.
We reviewed 1 1 shoulders of 10 patients ( 7 males,3 females,4 right,5 left,1 bilateral). All the patients had had snapping and pain with a positional reduction or dislocation. The average age at the operation was 18.7 years (range: 15-26 ), and the average follow-up period was 25 months (range,12-45months). The surgical procedure was as follows: a 7 cm longitudinal incision was made. The deltoid and the infraspinatus were split and the capsule was opened transversely. The cortex of the glenoid neck was exposed. The bone graft from the iliac crest (tri-cortical bone, length: 20mm, height: 15mm)was placed into the glenoid neck at the level with the articular surface, and secured by two compression screws. A posterior capsulorraphy was performed. The shoulders were immobilized with the arm in 20° abduction and slight external rotation. The screws were removed more than 6 months after the operation. Ten shoulders had no recurrence. One shoulder had a recurrence of posterior instability with a mild snapping (recurrence rate 9 % ) but in this case, the pain had vanished. Ten shoulders(91%)were pain-free. One shoulder had moderate pain and crepitus with shoulder motion. All eleven shoulders attained an almost full range of motion (average ROM: elevation 168 ° external rotation 88° , internal rotation Th 7-8). The grafted bone united with the glenoid neck 3-4 months after the operations. Resorption of the grafts occurred in all the shoulders and the length of the protruded portion posteriorly which had been about 15mm became 5-11mm (average 7.8 mm). Osteoarthrotic changes were not recognized in any of the eleven shoulders.
We recommend the posterior g lenoplasty using an iliac tri-cortical bone graft, because of its technical ease and good results.
