Single-Screw versus Two-Screw Fixation in the Latarjet Procedure: A Prospective Comparative Study

Recurrent anterior shoulder instability associated with glenoid bone loss frequently requires surgical stabilization. The Latarjet procedure addresses both bony deficiency and dynamic instability through a triple stabilizing mechanism. Controversy persists regarding the optimal method of coracoid graft fixation - single-screw versus two-screw - with ongoing debate about their biomechanical stability, complication profiles, and functional outcomes.

A prospective comparative study was conducted at the Department of Orthopaedics, Government Medical College and Hospital, Chh. Sambhajinagar, Chh. Sambhajinagar. Patients with recurrent anterior shoulder instability undergoing the Latarjet procedure were allocated to single-screw fixation (Group A) or two-screw fixation (Group B). Functional outcomes were assessed using the Constant-Murley score and clinical range of motion at follow-up. Radiological evaluation assessed graft union and positioning. Minimum follow-up was 3 months.

Both groups were comparable at baseline. At final follow-up, both groups demonstrated significant improvement in functional outcomes, with comparable Constant-Murley scores and range of motion recovery. Radiological evaluation showed high graft union rates in both groups. Recurrence rates were low and comparable. Hardware-related irritation was slightly higher in the two-screw group, while operative time was marginally shorter in the single-screw group. No significant difference was observed between groups in functional outcome, graft union, recurrence, or complication rates.

Both single-screw and two-screw fixation techniques in the Latarjet procedure provide comparable functional outcomes, graft union, and recurrence rates. Accurate graft positioning and meticulous surgical technique appear to be more critical determinants of success than the number of fixation screws.