Abstract
We present a surgical technique through an axillary incision to perform scapular neck osteotomy and insertion of bone graft for recurrent anterior dislocation of shoulder. Fifty patients in the age group 09–40 years with the history of anterior dislocation of shoulder more than three times were operated during 1988–1998. The dominant shoulder was involved in all cases and there was no history of epilepsy, addiction to drugs and psychosomatic ailments. The surgery was performed through an axillary incision. The lateral border of the scapula was palpated and infraglenoid tubercle identified. The scapular neck was osteotomised parallel to the glenoid margin, from infraglenoid tubercle to the lateral border of the base of coracoid leaving the superior cortex intact. The osteotomy was prised open and a 3 cmx1.5 cmx1 cm corticocancellous bone graft was wedgedwhich projected 10 mm anteriorly and 6 mm inferiorly. The graft remained secure and compressed in the osteotomy without any need of metallic fixation.The shoulder was immobilised in arm chest bandage for 4 weeks followed by mobilisation aimed to regain full movements in 12 weeks. The bone graft got incorporated in all patients in 6 months.There were no recurrence at follow up of 2–10 years. All the patients returned to their previous occupation. Rowes shoulder evaluation revealed excellent result (85–100 units). This surgical technique is extra-capsular, requires no muscle cutting, blood transfusion or metallic fixation. The projecting bone block anteriorly increased the depth of glenoid resulting in glenohumeral stability in larger arc of shoulder movements.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
