Contemporary methods of surgical treatment of recurrent dislocation of humeral head

Abstract

Introduction. A variety of operative techniques have been described as Bristow-Latarjet technique. In our study we described the experience of surgical treatment in patients with anterior shoulder instability using this procedure. Because of the anatomical peculiarities of shoulder joint, it is more predispose to dislocation. In 16-38% cases recurrent humeral head dislocations represents complication of primary dislocations in first 6 months from the primary injury. They are mostly characteristic for young men, aged between 20-30 years in 90% cases. The open Bristow-Latarjet procedure involves the partial transfer of the coracoid process with attached short tendon of biceps muscle to the front of the glenoid. This placement of the coracoid in „weak area of the joint” acts as a bone block combined with muscle insertion prevents further dislocation of the joint. Aim of the study. Analyze the results and indication for using open Bristow - Latarjet technique in patients with anterior recurrent dislocation of the shoulder. Materials and methods. This study includes 53 patients treated with open Bristow-Latarjet procedure. In 10 cases-dislocation was reduced by people with no medical studies, another 14 were without immobilization, in 12 cases was used posterior gyps, in other 10 soft Dessault bandage. In 12 patients was found deformation of anterior and anterio-interior labrum Results. The success of removing and replacement of coracoid process on the anterior part of glenoid fosa was appreciated: during surgery, in 3 weeks after surgery due to the movement in the shoulder joint, and in 6 weeks – according to the x ray results. It showed excellent outcomes in 14 patients, good outcomes in 32 patients and satisfying outcomes in 7 patients, all having started active functional treatment in 3 weeks after surgery. 47 patients mention full satisfaction with the outcomes, no one got recurrent dislocation after treatment. Conclusions. The Bristow-Latarjet surgery is used in treatment of recurrent dislocation of hummerus head with glenoid cavity dysplasia, because this technique ensures prevention of new recurrences and allows upper extremity function recovery in 95-98%.