R. Srikanth Varma1, Satish Kumar K2, P. S. Jaya Prasad3, Krishna Subramanyam4
BACK GROUND: Recurrent anterior dislocation of shoulder is a common orthopedic problem. The pathology is well known i.e. bank arts lesion, hill sachs lesion and capsular laxity. In the literature more than 150 types of surgeries were proposed but with their own limitations and recurrence. In the modified Boytchev procedure an active biomechanically dynamic sling is created by rerouting the conjoint tendon of coracobrachialis and short head of biceps under the subscapularis and fixed with a screw. This creates a(1) buttressing effect over anterior portion of head of humerus and(2) improves the stretch proprioceptive reflex in the subscapularis muscle and thus early and effective contraction of subscapularis.
MATERIALS AND METHODS: This paper discusses our experience and results in the treatment of recurrent anterior dislocation of shoulder in 22 patients (n=22) during the period Aug 2007 to Dec 2011, with age group of 21-49 years with mean age 30.6 yrs with a mean follow up of 96.3 weeks with mean preop dislocations 10.5.All patients were evaluated by Visual analogue score {VAS} and Modified American Shoulder and Elbow Surgeon Score {ASES} at each follow up. The scores were statistically compared at each follow up.
RESULTS: There were no dislocations in any of the patients. All patients had significant improvement in visual analogue score and modified American Shoulder and Elbow surgeon score at the last follow up. There was no loosening of screw at all the follow ups. One patient had screw removal. There was no loss of shoulder range of motion.
CONCLUSION: The technically simple modified Boytchev procedure is an effective surgical treatment for recurrent anterior dislocation of shoulder.
