Title: Functional Outcome Following Bristow and Boytchev Surgery in Recurrent Dislocation of Shoulder

Authors: Dr Sabarisree M, Dr Shrijith M.B

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i5.108

Abstract

Introduction: The aim of the treatment of recurrent dislocation shoulder is to achieve a stable and painless glenohumeral joint with complete range of motion .Various surgical procedures have been enumerated. With this study we compare two commonly done procedures for the treatment of recurrent dislocation of shoulder.

Materials and Methods: It was a prospective case series study design done at Orthopaedics department,  Govt Medical College Trivandrum from July 2012 to August 2014 who presented with recurrent anterior dislocation shoulder. We used Descriptive statistical analysis (SPSS). Sample size was 40 patients with recurrent anterior dislocation of shoulder. They were admitted through either emergency department or outpatient department of Medical College Hospital Trivandrum. These patients were followed up for 24 months -30 months

Results: Shoulder dislocation is more prevalent in younger age group <30 years, more in muscular individuals. There was a positive co relation between period of immobilisation post dislocation and further recurrences. More the dislocation frequencies, lesser was the Rowe functional score.

Recurrence rate in patients who underwent Boytchev surgery (40%) were higher and statistically significant as compared to the Bristow surgery (10%). Mean external rotation deficit in Boytchev surgery (28+/- 2 degree) were higher than the Bristow surgery (20+/-2 degree) .Patients who underwent Bristow surgery  had less recurrent dislocation  and lesser  shoulder pain and better Rowe score (60 % good functional score, 10 % poor Rowe score)  as compared to those who underwent Boytchev surgery(45% good functional score, , 40 % poor functional score )

Conclusion: Patients who have undergone Bristow surgery had better Rowe functional shoulder score as compared to boytchev surgery. Predisposing factors for shoulder dislocation were improper post-dislocation immobilisation. mean external rotation deficit was more in Patients who have undergone Boytchev surgery.

Keywords: Recurrent dislocation of shoulder, Boytchev surgery, Bristow procedure.

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Corresponding Author

Dr Sabarisree M

Associate Professor (CAP) in Orthopaedics

Govt Medical College, Thiruvananthapuram