Bone buttress operation for recurrent anterior shoulder dislocation in epilepsy

Abstract

Patients suffering from generalised convulsions may dislocate their shoulders either anteriorly or posteriorly. Those with anterior dislocation are likely to have recurrent episodes because of secondary bony damage to the anterior rim of the glenoid and head of the humerus. In such patients there is high rate of failure of the standard soft-tissue stabilisation procedures. We have therefore devised a bone buttress operation in which autograft or allograft is secured to the deficient anterior glenoid and shaped to form an extension of its articular surface. We report our experience in 14 patients with grandma! epilepsy and recurrent anterior dislocation of the shoulder. After the bone buttress operation there were no further dislocations and all patients were satisfied despite a small restriction in their range of movement. We believe this to be the operation of choice for patients with this difficult problem.

Prediction of coracoid thickness using a glenoid width–based model: implications for bone reconstruction procedures in chronic anterior shoulder instability

“…A number of authors advocate the use of allograft or autograft structural bone grafting. 4,6,9,19,20,22,24,34,37,42 Autologous ICBG provides a nearly limitless amount of graft that is high contourable and non-immunogenic and offers both osteoinductive and osteoconductive properties. 3,18 Harvesting of autologous ICBG, however, is not without risk and is associated with complication rates of up to 25%, including transient or permanent lateral femoral cutaneous nerve palsy, deep hematoma, infection, persistent donorsite pain, herniation of abdominal contents through massive donor sites, and fracture of the iliac wing.…”

“…Structural bone graft options include autologous tricortical iliac crest bone graft (ICBG), as well as distal tibial, femoral head, and ICBG allograft. 22,32,33 Latarjet 26 first described his eponymous coracoid transfer procedure in 1954. The coracoid and attached conjoined tendon are transferred to the scapular neck to restore the bony surface area and articular arc of the anteroinferior glenoid.…”

Anterior instability of the shoulder after trauma

“…This applies particularly to epileptics with recurrent traumatic instability who often have a large anteroinferior deficiency. 71,72 In patients with large, engaging HillSachs defects, allograft bone grafting or rotational osteotomy may also be considered. Arthroscopic stabilisation.…”

Bilateral, locked, recurrent anterior shoulder dislocation: case report

“…After surgical repair, redislocation rates are high which account for 50% of all surgical procedures. [15,16] In the literature, Connolly [17] introduced anterior stabilization with infraspinatus tendon transfer to repair anterior dislocations. Purchase et al [13] used remplissage technique with arthroscopic Bankart repair in 2007.…”