MANAGEMENT OF ANTERIOR SHOULDER INSTABILITY WITH SEVERE GLENOID BONE LOSS (> 25%) TREATED BY OPEN LATARJET PROCEDURE- CASE SERIES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 18
Abstract
BACKGROUND Arthroscopic management of glenohumeral instability with Bony Bankart’s lesion (> 25% bone loss) have been associated with high rates of recurrence in glenohumeral osseous defects. In such patients, Latarjet procedure can be considered as better solution. MATERIALS AND METHODS Total 10 patients were studied. Bony defect of the anterior glenoid (> 25%) with three or more previous dislocation were included. Latarjet operation makes use of large coracoid bone graft to extend glenoid articular surface by means of lengthened bone platform, dynamic stability is provided by conjoint tendon, static stability given by coracoacromial ligament. Constant-Murley score was used to evaluate results. Postoperative Management- Immobilisation in sling for first 6 weeks with limited abduction, flexion and external rotation. Antiinflammatory pain medications were avoided in early postoperative period to optimise osseous healing. Active strengthening is permitted once osseous healing is visualised. RESULTS Osseous union of graft was achieved in all patients. There was no recurrence of instability. Average follow-up period was 24 months. Average forward flexion was 160 and external rotation was 42.2. Mean postoperative Constant-Murley score was 80. Abduction and external rotation were minimally reduced. 2 patients had post-op superficial wound infection, which was treated with IV antibiotics. CONCLUSION Open Latarjet reconstruction can successfully restore shoulder stability and range of movements in joints with a significant bony defect of the glenoid even in elderly patients. It is effective in situations in which soft-tissue reconstruction is not a reasonable option.
Authors and Affiliations
Vijayaragavan Pugalenthi, Rathinam Arivasan, Thanga Muthu Saravana Muthu, Rama Krishnan Muthusamy
Keywords
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- EP ID EP418115
- DOI 10.14260/jemds/2018/516
- Views 65
- Downloads 0
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