2000 Volume 24 Issue 3 Pages 421-424
We analyzed the clinical results of a modified Bristow procedure and the changes of arthroscopic findings before and after surgery to confirm the relative advantages and the disadvantages of this procedure. Thirty-two patients (25 men,7 women) who underwent modified Bristow procedures was evaluated. The average age was 26.5 years. The average follow-up period was 47.6 months. Arthroscopy was performed on 16 shoulders preoperatively and on 5 shoulders postoperatively. Postoperative arthroscopy was performed at the time of the removal of the screw. The surgical results were evaluated according to JOA shoulder instability score. The changes of arthroscopic findigs, ligament, labrum injury and bone and cartilage defects were investigated. After a Bristow procedure, JOA score averaged 89.5 points (before surgery: 52.4 points). Two patients had a non-union of the transferred coracoid. One of these two had a recurrent dislocation. Only one of the nine athletes whose dominant side was affected in an over head throwing sport returned to it. In preoparative arthroscopies, we noted that the severity of the labrum injury and bone defects of the humeral head had increased according to the number of dislocations. In postoparative arthroscopies, congested membrane covered the articular side of the transferred coracoid. Bone defects and labrum injuries did not change, and cartilaginous defects of the glenoid which had not been seen before surgery were seen in two cases. Modified Bristow procedure is one of the good operations which prevent redislocation. But from the arthrocopic findings showing an anterior instability indicated that this procedure cannot maintain the centripetal position and this may lead to an osteoarthritic change in the future.
