Effectiveness of Modified Boytchev Procedure in Recurrent Anterior Dislocation of Shoulder irrespective of the Lesion
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 3672-3676
AbstractBackground: Recurrent anterior dislocation of shoulder is very commonly encountered problem and many different operations have been described for its treatment. On review of long term result of this procedure in literature, modified boytchev procedure is an ideal procedure for treatment of recurrent anterior dislocation of shoulder but none of the study of this procedure describes the lesion responsible for dislocation in literature.
Material & Methods: The mean number of dislocations in patients was 10.22±3.08 (4-20) times. All patients had a traumatic onset of symptoms and had a failure of initial nonoperative management All patients divided in three group according to lesion on MR arthrogram.
Results: All patients had significant improvement in VAS score, modified ASES score, and SANE score at the last follow up after the procedure. Each of the patients returned to the preoperative level of their respective activity. Two patients developed transient musculocutaneous nerve paresis that got resolved spontaneously within three months. There was no radiological evidence of Lossening, migration of coracoids screw or any glenohumeral instability.
Discussion: Modified boytchev procedure neither belongs to anatomic nor belongs to nonanatomic repairs group. The modified Boytchev procedure acts by two possible mechanisms dynamic muscular sling effect8,9 and improved shoulder joint proprioception.
Conclusion: The result of our study indicates that the lesions thought to be responsible for recurrence of dislocation are not the cause but the effect of recurrence of dislocation. The result of our study also supports the hypothesis that the dynamic muscular imbalance and reduced shoulder joint pressure responsible for recurrence which leads to lesion thought to be responsible for recurrence
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