Abstract
Our method improved the Putti-Platt procedure (P-P procedure) by cutting the subscapular tendon and joint capsule together with the non-detached coracoid process. The purpose of this study was to investigate the long term results (more then ten years) of this modified P-P procedure.
124 recurrent dislocations except habitual, voluntary, paralytic and non- traumatic dislocations or subluxations of the shoulder with more then ten years since surgery. Of them,52 shoulders were exmined. The average follow-up period was 15.6 years.
Redislocation of the shoulder could be observed in only one patient, and she had no further recurrence.8 cases take care of their redislocations,2 shoulders had anterior instabilities.The improvement of the external rotational angle was 52.4% in the 1st. plane and 65.8% in the 2nd. plane. The percentages of return to sports was 100% in judo and 50% in baseball. On MRI, the subscapular tendon looked thick and fibrosis of the tendon could be seen in some cases. Although, there were no osteoarthritis changes in the X-rays,28% of the cases had a focal osteoarthritis change at the anterior humeral head in the MRIs.
The percentage of a dislocation was very low. Not only our surgical procedure, but also the appropriate indications for surgery could make the results excellent. The diminution of elasticity in the subscapular tendon after surgery might cause the focal OA change at the humeral head.
