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Recurrent posterior instability of the shoulder
J F Hinojosa1, A Fery, D Schmitt
1Clinique de Traumatologie et d'Orthopédie, Professeur Jean Sommelet, Nancy, France.
International Surgery
|October 1, 1989
Summary
Surgical treatment for recurrent posterior shoulder instability shows variable outcomes. Proper graft positioning in posterior bone block procedures is crucial for success, with long-term osteoarthritis developing only in iatrogenic cases.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Shoulder Instability
Background:
- Recurrent posterior shoulder instability is a challenging condition.
- Surgical interventions aim to restore stability and function.
Purpose of the Study:
- To evaluate the long-term outcomes of surgical treatments for recurrent posterior shoulder instability.
- To identify factors influencing treatment success and failure.
Main Methods:
- Review of seven cases with recurrent posterior shoulder instability (subluxation or dislocation).
- Surgical treatments included inverted Putti-Platt, glenoplasty, and posterior bone block procedures.
- Long-term follow-up ranging from 3 to 17.5 years (mean 8.5 years).
Main Results:
- Clinical history and physical examination were the most accurate diagnostic tools.
- Outcomes included three excellent, one fair, and one poor result, with two failures.
- Technical errors, particularly graft malpositioning in bone block procedures, led to poor results.
- No significant long-term osteoarthritis development, except in iatrogenic cases.
Conclusions:
- Posterior bone block procedures require precise graft placement (at least 15 mm beyond the glenoid rim) for optimal outcomes.
- Functional results remain stable over time, barring the development of osteoarthritis.
- Early diagnosis through clinical assessment is key for effective management.