Outcome of Latarjet Technique with low Profile Single 4.0 MM Titanium Screw and Washer for Recurrent Dislocation of Shoulder: A Prospective Study
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 5
Abstract
Shoulder joint is one of the commonest joint to dislocate and account for majority of all the dislocations seen in the orthopaedic emergency department. Shoulder joint is prone for dislocations because of a shallow glenoid that articulates only with a small part of the humeral head. Recurrent dislocation of shoulder is also a common occurrence after first episode of dislocation and is seen more commonly in young patients having rotator cuff injuries or fracture of glenoid during initial dislocation. Management of recurrent dislocation is essentially surgical. Latarjet technique, first described by Latarjet M in 1954, is found to have excellent outcome in cases of recurrent shoulder dislocation. It consists of removal and transfer of a section of the coracoid process and its attached muscles to the front of the glenoid. The definitive graft fixation may be achieved using cortical screws and washers. We conducted this prospective study to analyze the outcome of patients having recurrent dislocation of shoulder treated by Latarjet technique using single 4.0mm titanium screw and washer. Aims and Objectives: To study clinical outcome and complications in patients with recurrent shoulder dislocation managed with Latarjet-Bristow procedure using single 4.0 mm titanium screw and washer. Materials and Methods: The study was carried out in department of orthopaedics in a teaching institute situated in an urban area. All patients admitted for recurrent shoulder dislocation and managed with Latarjet-Bristow procedure using single 4.0 mm titanium screw and washer were included in this study depending upon inclusion criteria. Any patient having any exclusion criteria was excluded from the study. Type of shoulder dislocation was diagnosed on the basis of imaging. X-Ray shoulder (AP view, internal rotation, external rotation and neutral position) was done in all the cases. 3 D CT of shoulder joint and MRI were done in selected cases. All patients underwent Latarjet-Bristow procedure and graft fixation was achieved using single 4.0mm titanium screw and washer. The outcome of patients was studied by analysing pre-operative and post operative Walch-Duplay and ROWE score scores. Results: Out of 30 cases there were 22 (73.33 %) Males and 8 (26.66 %) females with a M: F ratio of 1: 0.36. The most common affected age group was found to be between 26-35 years (40%) followed by 18-25 years (33.33%) and 36-40 years (20%) and most common mechanism of injury during first episode of shoulder dislocation was found to be fall (43.33%) followed by motor vehicular accidents (40 %) and sports injury (16.66 %). In 19 (63.33 %) patients shoulder dislocation was seen on right side and in 11 (36.66 %) patients the dislocation was seen on left side. Postoperatively 27 (90%) and 26 (86.66%) patients had either excellent or good outcome on the basis of Walch-Duplay Scores and ROWE score respectively. Post operative complications were seen in 4 (13.33%) patients and included hematoma, wound infections and nerve injury (neuropraxia) which resolved within 6 weeks. Conclusion: In patients with recurrent shoulder dislocation Latarjet-Bristow technique using 4.0-mm titanium screw and washer for graft fixation is an excellent procedure with satisfactory outcome and low complication rates.
Authors and Affiliations
Dr Satishkumar A Patil
Keywords
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