AN EVALUATION OF THE PUTTI-PLATT RECONSTRUCTION PROCEDURE FOR RECURRENT DISLOCATION OF THE SHOULDER

Abstract

1. A study of the two-year functional end results of forty-one Putti-Platt reconstruction operations has shown that this procedure is effective in the treatment of recurrent dislocation of the shoulder, regardless of the etiology or the pathological changes. The procedure is available to any qualified surgeon and no special surgical equipment is required. 2. The simplified operation has been as successful as the original technique and has the advantages of decreasing the length of the incision, lessening the amount of tissue trauma, minimizing intra-articular operative damage, and shortening both the duration of the operation and the period of rehabilitation. 3. Shoulders in which original traumatic dislocation has occurred should be completely immobilized for a minimal period of four weeks, regardless of the mechanism of injury, in order to reduce the possibility of recurrence. Dislocations which are spontaneous will probably recur with or without immobilization. 4. Operative correction should be reserved for disabling recurrences in young individuals who are willing to accept the attendant postoperative limitation. 5. Because of the friability of the soft tissues secondary to the trauma of dislocation, operative repair should not be attempted in less that thirty days after any recurrence. 6. Since in all three of our operative failures, the patients had persistent limitation of external rotation, it is suggested that the effectiveness of the procedure is due principally to the resistance given to the anterior thrust of the humeral head by the operative scarring and by the shortened capsular and muscle structures.