Abstract
Shoulder dislocation is common problem in orthopaedics. Management of recurrent shoulder dislocation is painstaking with different surgical procedures having varying outcomes. Laterjet-Bristow procedure provides stability and good functional outcome in Rowe scale and long term patient satisfaction. This is an observational prospective study carried out at two different tertiary care centers at Nepal and Pakistan using the same protocol. Habitual and pathological recurrent dislocations were excluded and all the recurrent dislocation of shoulder following initial traumatic anterior dislocation was included in this study. Standard Laterjet-Bristow operation was done and followed up for average of 27 months. Functional evaluation was done using Rowe score and graded as excellent, good, fair and poor. There were 12 men and 9 women with the mean ages of 23.4 years. At 12 months, 11 patients had fair result and seven patients had good result. At two years only three had fair result, 15 had good result and three patients had excellent result. Only three patients had poor result at one year while none had poor result at two year. The mean loss of external rotation in operated shoulder at one year was 24.33 degrees which decreased to 21.2 degrees at the end of second year. There was no restriction of external rotation in three patients at both yearly follow-ups while 18 patients had restriction in the range 10-30 degrees. Laterjet-Bristow can be the procedure of choice for surgical treatment of recurrent traumatic anterior dislocation and also as a salvage surgery for failed cases from other types of procedures. The only shortcoming of this procedure was some limitation in external rotation and minor loss in muscle power of that shoulder.
Highlights
The only shortcoming of this procedure was some limitation in external rotation and minor loss in muscle power of that shoulder
Recurrence of dislocation in shoulder reaches up to 8090% in young adults and are disabling
Coracoid transposition following course of the conjoint tendon of short head of Biceps and Coraco-Brachialis provides mechanical block and dynamic support in positions of vulnerability providing good stability to the Gleno-Humeral joint. It can be the procedure of choice for surgical treatment of recurrent traumatic anterior dislocation and as a salvage surgery for failed cases from other types of procedures
Summary
Recurrence of dislocation in shoulder reaches up to 8090% in young adults and are disabling. More than 150 operations has been described. Some how for fear of screw related technical difficulty and complications, Bristow procedure is not so popular. Our experience with this procedure in comparision with other popular simpler procedures in our practice had been superior in Rowe scale. Transfer of the tip of the coracoid process to the anterior margin of the glenoid was first described by Laterjet for treatment of recurrent dislocation of the shoulder.[1] Helfet used sutures to hold the coracoid tip.[2] Mead screwed the coracoid to the anterior glenoid rim.[3]
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