[The value of Sowinski coracoid-plasty for recurrent dislocation of the shoulder]

The value of Sowiński coracoplasty for recurrent, trauma related dislocation of the shoulder was evaluated on the basis of multidirectional clinical, Xray, CT and ultrasound examinations in 15 patients operated on between 18 and 40 years of age. Good results were achieved in 14 cases after 2-14 years follow up. In one case of epileptic patient 4.5 years after surgery traumatic dislocation of the shoulder occurred with a fracture of incorporated bony graft. The authors have proved the coracoplasty performed to be efficient in preventing recurrent dislocation of the shoulder by means of creating new biomedical conditions around the joint. The bony graft by elongation of the coracoid process of ca 35 mm and change in its alignment imposes strong mechanical support for the head of the humerus and indirectly makes the acetabulum deeper. The graft located above anterior rim of the acetabulum increases the tension of subscapular muscle and stabilizes the capsule thus aiding to the stability of the joint. In 4 cases some adhesions between the graft and subscapularis muscle have slightly restricted external sotation of the shoulder.