Oldie but Goldie: Bristow-Latarjet Procedure for Anterior Shoulder Instability

Abstract

The Bristow-Latarjet procedure is a good surgical treatment for recurrent anterior-inferior instability of the glenohumeral joint.

Etiology of Primary Dislocation in Recurrent Anterior Shoulder Instability: A Cross-Sectional Study

“…The reason for the first dislocation was a traumatic event in forty-six cases (94%) and minor trauma in three (6%).Sports injury was found in majority of patients Matthes G et. al., [4] 2007 evaluated 100 patients with recurrent anterior shoulder instability and assessed overall stability and function of shoulder.83 of 100 cases had a traumatic etiology of their primary dislocation while 17 of 100 patients sustained no or trivial trauma at the time of primary dislocation. Overhead throwing was the commonest cause and most commonly affected population was competitive athletes.…”

Recurrent Shoulder Dislocations Secondary to Coracoid Process Fracture: A Case Report

“…The Latarjet procedure and modified Boytchev procedures keep the subscapularis inferior to the equator of the humeral head in overhead abduction, as they are routed through it, and thus protect the shoulder from dislocation. 18,19 Fixation of the coracoid process with its attached tendons (after routing through the subscapularis to reinforce the anterior wall) was effective in stabilising the shoulder. Restoration of corocoid anatomy should be sufficient to stabilise the shoulder, because of the stabilising role of the coracoid-conjoint tendon complex.…”

“…20,23 Other studies report comparable outcomes following the extra-articular, non-anatomic Bristow-Latarjet procedure with open techniques. 19 Thus, the modified extra-articular Boytchev procedure was used to fix the fractured coracoid tip to its parent by rerouting it through the subscapularis. This kept the subscapularis and conjoint tendon approximated to the anteroinferior aspect of glenohumeral joint, and thus acted as a static anterior shoulder stabilising apron.…”

“…24,25 As the coracoid fragment with its attached conjoint tendon was passed through the lower third of the subscapularis, which was kept inferior to the equator of the humeral head in overhead abduction. 18,19 The pressure between the humeral head and the subscapularis tendon was increased. This enhanced proprioceptive stimuli in the subscapularis tendon and thus accelerated the protective reflex needed to prevent shoulder dislocation.…”

The chronically unstable shoulder joint after surgical reconstruction

“…Dieser Wirkmechanismus ist insbesondere bei kombinierter Abduktions-Außen-rotationsbewegung als hauptsächliche Sub-und Luxationsbewegung von entscheidender Bedeutung, da in dieser Situation die dynamische Muskelschlinge die stabilisierende Funktion des geschä-digten Kapsel-Labrum-Glenoidkomplexes (IGHL) übernimmt. In der Literatur werden beim Korakoidversatz Schraubenlockerung (0-26%), Dislokation (0-14%) und Pseudarthrose (0-10%) als verfahrensspezifische Komplikationen angeführt [12]. Die Reluxationsrate nach Korakoidversatz wird mit Werten zwischen 0% und 7%, bei Einschluss der Subluxationen zwischen 0% und 13,4% angegeben [9].…”