Management of Recurrent Anterior Shoulder Dislocation by Modified Boytchev Procedure- Our Experience

Abstract

Background: Recurrent anterior shoulder dislocation is not uncommon. Although the etiology for recurrent anterior shoulder dislocation is not very clear, there are 3 lesions usually responsible for its occurrence: Bankart lesion, Hill-Sachs lesion and laxity of subscapularis muscle. Several operations have been described for the treatment of recurrent anterior dislocation of shoulder but only a few of them have good result in terms of recurrence and loss of shoulder movement in follow-up period. Modified Boytchev procedure is an effective, technically simple procedure for the management of recurrent anterior dislocation of shoulder. Methods: Ten patients with recurrent anterior dislocation of the shoulder were treated from September 2017 to August 2019 by the modified Boytchev procedure. The age of the patients varied from 20 to 38 years (average 25.6 years). Outcome was evaluated using the Burkhead and Rockwood criteria, a score of 90 to 100 was considered excellent, 70 to 89 good, 40 to 69 fair and ?39 was considered poor. Results: The mean follow-up period was 15.4 (SD=3.2; range=6-29) months. Outcome was excellent in 7 patients, good in 2, and fair in 1. None had poor outcome. The shoulders were stable with increased ROM in all directions. Mean external rotation deficit at 0o and 90o of improved from 18o to 7o and 21o to 10o respectively (student's paired t-test). Conclusions: This is an effective, technically simple procedure with minimum restriction of movements around the shoulder joint and does not require expert skills.