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Journal of the Korean Shoulder and Elbow Society 2001;4(2):181-185.
Published online December 30, 2001.
Bilateral Anterior Shoulder Instability
Yong Girl Rhee, M.D., Nam Su Cho, M.D.
Department of Orthopedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea
양측 견관절에 발생한 전방 불안정성
이용걸, 조남수
경희대학교 의과대학 정형외과학교실
Abstract
Purpose
: We reviewed the bilateral anterior shoulder instability to evaluate the final outcomes and influencing factors that had effect on the final outcomes. Materials and Methods : Sixteen patients of the bilateral shoulder instability underwent the operative treatment and 15 patients could be followed up average 29 months. There were Bankart lesions in 28 cases and 46% retracted markedly onto the medial side of the glenoid neck. Capsular redundancy could be seen in 50%, but the generalized ligamentous laxity in only two patients. We performed open Bankart repair in 21 cases and arthroscopic repair in 9 cases. Inferior capsular shift was performed in 12 cases of 15 cases in patients who was shown the capular redundancy. Results : The average increment of the forward flexion was 40 postoperatively but the average decrement of the external rotation was 60 postoperatively. After the inferior capsular shift surgery, there were significantly the decrement in external rotation by 130 even though the forward flexion was at the same level comparing with preoperative motion. There were 13 cases(43%) in excellent result, 14 cases(47%) in good and 3 case(10%) in poor. Rowe score improved from 53 to 87.3 postoperatively. Conclusion : Re-establishing a proper capsular tensioning in a bilateral anterior shoulder instability is critical to ultimate success because there was a redundant laxity in a half and majority of them had marked retraction of an anteroinferior glenohumeral ligament complex. Especially, it should be considered that an unexpected limitation of external rotation could be occurred in the inferior capsular shift surgery.
Key Words: Shoulder, Bilateral anterior instability, Bankart repair


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