[Treatment of recurrent post-traumatic anterior-inferior glenohumeral instabilities with the selective capsular shift technique].
OBJECTIVE
We evaluated the functional results of treatment with the selective capsular shift technique in patients with recurrent post-traumatic anterior-inferior glenohumeral instability.


METHODS
The study included 16 patients (15 males, 1 female; mean age 30 years; range 25 to 38 years) who underwent selective capsular shift operation for recurrent post-traumatic anterior-inferior glenohumeral instability. Dislocations occurred following severe (n=14) or mild (n=2) trauma. Preoperatively, the mean number of dislocations was 14 (range 4 to 45) and magnetic resonance imaging showed a Bankart lesion in all the patients and a Hill-Sachs lesion in 20%. The patients were evaluated according to the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and Rowe's scoring for Bankart repair. Preoperative and postoperative anteroposterior and axillary x-rays were obtained from all the patients. Range of motion was measured with a goniometer and manual muscle strength tests were performed. The mean follow-up was 41 months (range 21 to 74 months). Statistical analysis was made using the t-test.


RESULTS
The mean preoperative and postoperative ASES scores differed significantly (63.2 vs 95.8; p<0.05). The mean Rowe score was 92.5 (range 70 to 100). Strength of the infraspinatus, supraspinatus, and subscapularis muscles increased significantly (p<0.05). The results were excellent in 12 patients (75%), good in two patients (12.5%), and fair in two patients. Fifteen patients (93.8%) expressed satisfaction with the operation and results.


CONCLUSIONS
Addition of the selective capsular shift technique to the Bankart repair procedure improves stability and preserves the range of motion of the glenohumeral joint in patients with anterior-inferior glenohumeral instability accompanied by a Bankart lesion and capsular injury or laxity.
Ozbaydar
Mehmet Uğur
MU
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Kliniği), Istanbul Okmeydani Training and Research Hospital, Istanbul, Turkey. mehmetozbaydar@hotmail.com
Tonbul
Murat
M
Altun
Mehmet
M
Yalaman
Okan
O
D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures; D011859:Radiography; D016059:Range of Motion, Articular; D012008:Recurrence; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012785:Shoulder Joint; D016896:Treatment Outcome