Treatment of Chronic Anterior Shoulder Dislocation by Coracoid Osteotomy with or without Bristow–Latarjet Procedure

Abstract

Objective: To investigate the clinical efficacy and outcomes of the coracoid osteotomy with or without Bristow-Latarjet procedures in the treatment of chronic anterior shoulder dislocation (CASD). Methods: Between January 2013 and January 2019, 20 shoulders of 18 patients who were diagnosed with chronic anterior dislocation and underwent open reduction in our trauma center were retrospectively studied. Open coracoid osteotomy with Bristow-Latarjet procedures were performed on 16 shoulders and open coracoid osteotomy without Bristow-Latarjet procedures were performed on four shoulders. Open coracoid osteotomy with or without Bristow-Latarjet procedures were chosen on the basis of the stability of the shoulder after reduction. Outcomes were assessed preoperatively and postoperatively with the visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the University of California Los Angeles (UCLA) shoulder rating scale, and the range of motion (ROM) for shoulder activity. Results: There were three males and 15 females with an average age of 60.94 AE 2.69 years. The time between dislocation and treatment ranged from 21 to 240 days with an average of 73.3 AE 14.4 days. All patients were available for a mean follow-up of 15.2 AE 4.3 months. No procedure-related death or incision-related superficial or deep tissue infection was identified in all cases. No iatrogenic neurovascular injuries or fractures were found in this study. At the time of 12 months follow-up, the range of motion and the shoulder functional evaluation (VAS [P < 0.001], ASES [P < 0.001], and UCLA score [P < 0.001]) in patients who underwent Bristow-Latarjet procedures were significantly improved. Subluxation after surgical procedure was found and confirmed in one patient and this patient refused to undergo revision surgery. According to the Samilson and Prieto classification system, 16 shoulders were assessed as grade 0, three shoulders were grade 1, one shoulder was grade 2. Conclusions: Coracoid osteotomy with or without Bristow-Latarjet procedure yielded an acceptable clinical result in this study. This method has the advantages of enlarging the exposure of surgical field, assisting reduction of shoulder, and convenient conversion to Bristow-Latarjet procedure. It is an efficient and reliable method for treatment of chronic anterior shoulder dislocation. A 69-year-old woman diagnosed with right chronic anterior shoulder dislocation with large Hill-Sachs lesion. The latarjet procedure with remplissage technique was applied for this patient.

Treatment of Bony Defects in Anterior Shoulder Dislocation-Latarjet Procedure: Short-Term Results

“…The result was agreed with results attained by Yang et al (12) who reported that the range of motion (ROM) and the shoulder functional evaluation (visual analogue scale [P< 0.001], American shoulder and elbow surgeon's score [P< 0.001], and UCLA score [P< 0.001]) in patients who underwent Bristow-Latarjet procedures were significantly improved. However, Moroder et al (13) reported that Strength and range of motion showed no significant differences except for diminished internal rotation capacity in the Latarjet group at every follow-up time point (P < .05).…”

Arthroscopic Reduction of a Missed/Neglected Anterior Shoulder Dislocation and Concomitant Repair of the Rotator Cuff Tendon

“… 5 Open reduction of neglected anterior dislocations has been safely performed with variable outcomes. 1 , 4 , 9 The arthroscopic technique of relocating a missed anterior shoulder dislocation presented in this article has several advantages. Patients of the older age group and with osteoporotic bones are at increased risk of a surgical humeral neck fracture during forceful closed reductions.…”

Chronic Unreduced Anterior Shoulder Dislocation Managed by Latarjet Procedure: A Prospective Study

“…They concluded that operative intervention combined with meticulous physiotherapy contributes to a favourable outcome. Yang et al did a retrospective study on 20 shoulders of 18 patients, of whom 16 were managed by Latarjet procedure and four patients by Bristow procedure[15]. They found that there was a significant improvement in range of motion, VAS score, UCLA score, and American Shoulder and Elbow Surgeons (ASES) score in all the patients.…”