Titanium staple and screw fixation for recurrent dislocation of the shoulder

A small titanium staple with a locking screw was designed in 1979 to hold the anterior capsule of the shoulder firmly to the front of the scapula just medial to the glenoid. The posterior or inferior capsule can also be stabilized. Two indentations on the staple diminish capsular compression, while a central hole for a 4.5-mm titanium alloy cortical screw allows firm fixation of the staple. A small deltopectoral or axillary approach is used and the subscapularis and capsule are incised on the line of the muscle fibres. The operation is relatively simple and combines the advantages of a Bankart, bone block and capsular plication in a single small operative procedure. Full movement, including external rotation, can be started 3 days postoperatively, and most patients can return to manual labour or contact sport in 4 to 6 weeks. A total of 47 anterior dislocations and two posterior dislocations have been treated since 1981, including six failed Putti-Platt operations and one Helfet operation. Full shoulder movement is usually achieved within 3 weeks of operation.