Long-term results of surgical treatment of chronic posttraumatic anterior shoulder instability at the bone defect of scapula articular process

Abstract

According to the results of multi-layer spiral CT, the main reason of shoulder instability is a bone defect of scapula articular surface. Frequency of poor results after common surgical treatment is high and runs up to 30 % of cases. The aim of the research was to estimate long-term results of surgical treatment of patients with chronic posttraumatic anterior shoulder instability at the edge bone defect of scapula articular surface using restoration of the anatomy of scapula articular surface by free autograft. We conducted open controlled prospective randomized study in the clinic of Irkutsk Scientific Center of Surgery and Traumatology. Estimation of long-term results of surgical treatment was conducted by the next criteria: functional (range of motions of operated upper extremity), subjective (visual analogue scale of pain, integral estimation of functional results by Rowe - Zarins and DASH scales), objective (X-ray imaging of shoulder joint in -x views and multi-layer spiral CT) and complications. Estimation of functional and anatomic results of 34 patients in 3 years after the operation proved clinical effectiveness of proposed surgical method. Overall level of conclusiveness of the research can be defined as level B and the effect of treatment as class I. Therefore, using free autograft from iliac crest allows to restore lost surface of scapula cavity more than 15 % of total surface.