A Case of Recurrent Anterior Shoulder Dislocation Treated with a Bone Buttress Operation and Corrective Osteotomy of the Proximal Humerus

Abstract

[Introduction] Soft tissue operations for anterior instability have a high rate of failure in a patient with recurrent anterior shoulder dislocation and epilepsy, because of the extensive bone defects of the glenoid and posterolateral notch of the humerus. We wish to report our experience of a case of recurrent anterior bilateral shoulder dislocation treated with a bone buttress operation and corrective rotational osteotomy of the proximal humerus.
[Patient and methods] A 28-year-old-woman had been treated for epilepsy since she was 15 years old, but control was poor. The first bilateral shoulder dislocation with epilepsy occured when she was 15years of age, and the episode recurred. She underwent two stabilizing procedures on her right shoulder and one on her left shoulder in another hospital, but the results were unsuccessful. The radiographs showed extensive bone befects of the glenoid, the posterolateral notch of the humerus and rhe anteversion of the humeral head. After the epilepsy was controled, we performed a bone buttress operation and corrective rotational osteotomy of the proximal humerus on her left shoulder.5 months later, we performed the same procedure on her right side. After the operation the arm was immobilized for four weeks, after which it mobilized.
[Results] She had no dislocations at the follow-ups 14 months after her left shoulder operation or 11months after the right shoulder. The flexion was 160°, abduction was 160°, external rotation was 80. and internal rotation was 90° after the operations. Although she had a slight pain in her left shoulder, she had no problems in her daily life.
[Conclusion] We think a bone buttress operation and corrective rotational osteotomy are effective procedure for the recurrent shoulder dislocation and epilepsy.