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Complications in Modified Bristow Procedure

Year 2004, Volume: 5 Issue: 3, 27 - 31, 01.12.2004

Abstract

Amaç:Rekürrent anterior omuz instabilitesinin tedavisinde uzun yıllar başarı ile uygulanan modifiye Bristowameliyatında çeşitli komplikasyonlar ortaya çıkabilir. Bu çalışmada travmatik rekürrent anterior omuz çıkığınedeniyle Bristow ameliyatı yapılan olgularda ortaya çıkan komplikasyonlar ve tedavileri araştırıldı.Yöntem:Atatürk Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı'nda 1987-1995 yıllarıarasında travmatik rekürrent anterior omuz çıkığı nedeniyle 19 olgunun 20 omuzuna (1 kadın, 18 erkek, ortalamayaş: 23.7 yıl, dağılım 17-53 yaş) modifiye Bristow ameliyatı uygulandı. Ameliyat sonrası 1. 2. hafta ve 1. 2. 4. 6.ve 12. aylarda yapılan kontrollerde olguların fizik muayeneleri ve radyolojik kontrolleri yapıldı. Sonuçlarretrospektif olarak değerlendirilerek ortaya çıkan komplikasyonlar ve tedavileri incelendi. Ortalama takip süresi72 ay (36-98 ay) olarak tespit edildi.Bulgular:Olgulardan 1'inde (%5) ameliyat sonrası 8. ayda minör travma ile yeniden çıkık oluştu. İntraoperatifolarak 1 omuzda (%5) korakoid çıkıntı osteotomi sırasında kırıldı. Postoperatif dönemde 5 omuzda (%25)muskulakütanöz sinirin traksiyon injurisine bağlı omuz anterior ve anterolateralinde 1-6 ayda iyileşen hipoestezisaptandı. Omuzların 4'ünde (%20) skapular planda ortalama 11.2 elevasyon kaybı, 6'sında (%30)ortalama 12.5 iç rotasyon kaybı ve 12'sinde (%60) ortalama 20.8 dış rotasyon kaybı olduğu tespitedildi.Sonuç:Bristow ameliyatı omuzda tekrar çıkık oluşmasını önlemede başarılıdır. Ancak komplikasyonlarınınfazlalığı ve omuz dış rotasyon hareketini kısıtlaması nedeniyle olguların tedavisinde doğrudan patolojiye yönelikselektif yöntemlerin seçilmesi daha uygun olacaktır

References

  • 1. RomeoAA, Cohen BS, Carreira DS. Traumatic anterior shoulder instability. Orthop Clin North Am 2001; 32:399-409.
  • 2. Milgrom C, Mann G, Finestone A. A prevalance study of recurrent shoulder dislocations in young adults. J Shoulder Elbow Surg 1998; 7:621-624.
  • 3. Rowe CR. Acute and recurrent anterior dislocations of the shoulder. Orthop Clin NorthAm 1980; 11:253-270.
  • 4. Helfet AJ. Coracoid transplantation for recurring dislocation of the shoulder. J Bone Joint Surg 1958; 40- B:198-202.
  • 5. May MR. A modified Bristow operation for anterior recurrent dislocation of the shoulder. J Bone Joint Surg 1970; 52-A:1010-1016.
  • 6. Lombardo SJ, Kerlan RK, Jobe FW, Carter VS, Blazina ME, Shields CL. The modified Bristow procedure for recurrent dislocation of the shoulder. J Bone Joint Surg 1976; 58-A:256-261.
  • 7. Allman FL. Report of more than 300 Bristow procedures in athletes for recurrent dislocation/subluxation of the shoulder. Clin Orthop 1978; 133:261-282.
  • 8. Banas MP, Dalldorf PG, Sebastianelli WJ, DeHaven KE. Long term follow-up of the modified Bristow procedure.Am J Sports Med 1993; 21:666-671.
  • 9. Young DC, Rockwood CA. Complications of a failed Bristow procedure and their mamagement. J Bone Joint Surg 1991; 73-A:969-981.
  • 10. Zuckerman JD, Matsen FA. Complications about the glenohumeral joint related to the use of screws and staples. J Bone Joint Surg 1984; 66-A:175-180.
  • 11. Hovelius L, Körner L, Lundberg B, Akermark C, Herberts P, Wredmark T, Berg E. The coracoid transfer for recurrent dislocation of the shoulder, technical aspects of the Bristow-Laterjet procedure J Bone Joint Surg 1983; 65-A:926-934.
  • 12. Rowe CR, Patel D, Suthmayd WW. The Bankart procedure. J Bone Joint Surg 1978; 60-A:1-16.
  • 13. Binnet MS, Gürkan İ, Karakaş MA, Fezeli AR. Omuzun tekrarlayıcı çıkıklarının tedavisinde modifiye Bristow yöntemi yeterli mi? Acta Orthop Traumatol Turc 1998; 32:8-14.
  • 14. Singer GC, Kirkland PM, Emery RJH. Coracoid transposition for recurrent anterior instability of the shoulder. J Bone Joint Surg 1995; 77-B:73-76.
  • 15. Green A, Norris TR. Shoulder arthroplasty for advanced glenohumeral arthritis after anterior instability repair. J Shoulder Elbow Surg 2001; 10:539- 545.
  • 16. Hawkins RJ,Angelo RL. Glenohumeral osteoarthrosis. J Bone Joint Surg 1990; 72-A:1193-1197.
  • 17. Mirzanlı C, Caniklioğlu M, Ertürk C, Azar N, Mert M. Rekürrent anterior omuz çıkıklarında modifiye Bristow girişimi. Acta Orthop Traumatol Turc 1994;18-20.
  • 18. Rowe CR, Zarins B, Ciullo JV. Recurrent anterior dislocation of the shoulder after surgical repair. J Bone Joint Surg 1984; 66-A:159-168.
  • 19. Cole BJ, Romeo AA, Warner JP. Arthroscopic Bankart repair with the suretac device for traumatic anterior shoulder instability in Athletes. Orthop Clin North Am 2001; 32:411-421.
  • 20. Chroustovsky J, Malusek P, Jircik M, Konecny R. Treatment of anterior glenohumeral instability: personal experience with an arthroscopic stabilization technique, its indications and results. Acta Chir Orthop Traumatol Cech 2003; 70:164-169.

MODİFİYE BRİSTOW AMELİYATI KOMPLİKASYONLARI*

Year 2004, Volume: 5 Issue: 3, 27 - 31, 01.12.2004

Abstract

Objectives: The modified Bristow procedure is successful in preventing recurrent instablity but can result in some complications. We evaluated the complications and their treatment in patients with traumatic anterior shoulder dislocation who were treated with this procedure. Method: Between 1987-1995 twenty shoulders in nineteen patients (1 female, 18 male; mean age 23.7 years, range 17-53 years) with traumatic anterior shoulder dislocation underwent the modified Bristow procedure. The patients were evaluated clinically and radiologically at 1st and 2nd weeks and 1st , 2nd, 4th, 6th and 12th months The complications and their treatment were retrospectively analysed. The mean follow-up time was 72 months (36-98) months. Results: We had only one redislocation (5%) due to a minor trauma in the eighth month after surgery. The transferred tip of the coracoid was fractured in one shoulder (5%) during surgery. Five patients (25%) had hypoestesia on the anterior and anterolateral aspect of the shoulder due to musculocutaneous nerve traction injury which healed in 1-6 months. Motion loss was 11.20 (5-200) in elevation on scapular plane in four shoulders (20%),12.50 (5-300) in internal rotation in six shoulders (30%) and 20.80 in external rotation in twelve shoulders (60%). Conclusion: The Bristow procedure is succesful in preventing recurrent dislocations, but a wide range of minor and serious complications and loss of external rotation can occur. We concluded that anterior stabilisation procedures that focus on reconstruction of pathologic lesions should be preferred in these patients.

References

  • 1. RomeoAA, Cohen BS, Carreira DS. Traumatic anterior shoulder instability. Orthop Clin North Am 2001; 32:399-409.
  • 2. Milgrom C, Mann G, Finestone A. A prevalance study of recurrent shoulder dislocations in young adults. J Shoulder Elbow Surg 1998; 7:621-624.
  • 3. Rowe CR. Acute and recurrent anterior dislocations of the shoulder. Orthop Clin NorthAm 1980; 11:253-270.
  • 4. Helfet AJ. Coracoid transplantation for recurring dislocation of the shoulder. J Bone Joint Surg 1958; 40- B:198-202.
  • 5. May MR. A modified Bristow operation for anterior recurrent dislocation of the shoulder. J Bone Joint Surg 1970; 52-A:1010-1016.
  • 6. Lombardo SJ, Kerlan RK, Jobe FW, Carter VS, Blazina ME, Shields CL. The modified Bristow procedure for recurrent dislocation of the shoulder. J Bone Joint Surg 1976; 58-A:256-261.
  • 7. Allman FL. Report of more than 300 Bristow procedures in athletes for recurrent dislocation/subluxation of the shoulder. Clin Orthop 1978; 133:261-282.
  • 8. Banas MP, Dalldorf PG, Sebastianelli WJ, DeHaven KE. Long term follow-up of the modified Bristow procedure.Am J Sports Med 1993; 21:666-671.
  • 9. Young DC, Rockwood CA. Complications of a failed Bristow procedure and their mamagement. J Bone Joint Surg 1991; 73-A:969-981.
  • 10. Zuckerman JD, Matsen FA. Complications about the glenohumeral joint related to the use of screws and staples. J Bone Joint Surg 1984; 66-A:175-180.
  • 11. Hovelius L, Körner L, Lundberg B, Akermark C, Herberts P, Wredmark T, Berg E. The coracoid transfer for recurrent dislocation of the shoulder, technical aspects of the Bristow-Laterjet procedure J Bone Joint Surg 1983; 65-A:926-934.
  • 12. Rowe CR, Patel D, Suthmayd WW. The Bankart procedure. J Bone Joint Surg 1978; 60-A:1-16.
  • 13. Binnet MS, Gürkan İ, Karakaş MA, Fezeli AR. Omuzun tekrarlayıcı çıkıklarının tedavisinde modifiye Bristow yöntemi yeterli mi? Acta Orthop Traumatol Turc 1998; 32:8-14.
  • 14. Singer GC, Kirkland PM, Emery RJH. Coracoid transposition for recurrent anterior instability of the shoulder. J Bone Joint Surg 1995; 77-B:73-76.
  • 15. Green A, Norris TR. Shoulder arthroplasty for advanced glenohumeral arthritis after anterior instability repair. J Shoulder Elbow Surg 2001; 10:539- 545.
  • 16. Hawkins RJ,Angelo RL. Glenohumeral osteoarthrosis. J Bone Joint Surg 1990; 72-A:1193-1197.
  • 17. Mirzanlı C, Caniklioğlu M, Ertürk C, Azar N, Mert M. Rekürrent anterior omuz çıkıklarında modifiye Bristow girişimi. Acta Orthop Traumatol Turc 1994;18-20.
  • 18. Rowe CR, Zarins B, Ciullo JV. Recurrent anterior dislocation of the shoulder after surgical repair. J Bone Joint Surg 1984; 66-A:159-168.
  • 19. Cole BJ, Romeo AA, Warner JP. Arthroscopic Bankart repair with the suretac device for traumatic anterior shoulder instability in Athletes. Orthop Clin North Am 2001; 32:411-421.
  • 20. Chroustovsky J, Malusek P, Jircik M, Konecny R. Treatment of anterior glenohumeral instability: personal experience with an arthroscopic stabilization technique, its indications and results. Acta Chir Orthop Traumatol Cech 2003; 70:164-169.
There are 20 citations in total.

Details

Other ID JA77HV99MD
Journal Section Research Article
Authors

Namık Şahin This is me

Naci Ezirmik This is me

Publication Date December 1, 2004
Published in Issue Year 2004 Volume: 5 Issue: 3

Cite

EndNote Şahin N, Ezirmik N (December 1, 2004) MODİFİYE BRİSTOW AMELİYATI KOMPLİKASYONLARI*. Meandros Medical And Dental Journal 5 3 27–31.