HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) All Versions of this Article: 36/4/638    most recent 0363546507309672v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Google Scholar Articles by Auffarth, A. Articles by Resch, H. PubMed PubMed Citation Articles by Auffarth, A. Articles by Resch, H. Related Collections Dislocations Shoulder Operative

The J-Bone Graft for Anatomical Glenoid Reconstruction in Recurrent Posttraumatic Anterior Shoulder Dislocation

Alexander Auffarth, MD^*,, Josef Schauer, MD, Nicholas Matis, MD, Barbara Kofler, MD, Wolfgang Hitzl, PhD and Herbert Resch, MD

From the Department of Traumatology, Department of Radiology, and Department of Biostatistics, General Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria

^* Address correspondence to Alexander Auffarth, MD, Landeskrankenhaus Salzburg/Unfallchirurgie, Muellner-Hauptstrasse 48, A-5020 Salzburg, Austria (e-mail: a.auffarth{at}salk.at).

Background: Posttraumatic shoulder dislocations with glenoid rim fractures show high rates of dislocation recurrence. For glenoid rim defects exceeding a certain size, several investigators recommend bone grafting. Few reports on anatomical glenoid reconstruction addressing this problem are published.

Hypothesis: Anatomical glenoid reconstruction by the J-bone graft creates permanent joint stability without a clinically relevant loss of motion.

Study Design: Case series; Level of evidence, 4.

Methods: Forty-seven shoulders with glenoid rim fractures after recurrent anterior dislocation were stabilized by a J-bone graft. For clinical outcome, motion and strength compared with the uninjured shoulder, as well as sports activity, were recorded. The Rowe score and the Constant-Murley score were used for scoring. In cases of follow-up exceeding 6 years, computed tomography scans were obtained and compared to preoperative radiographs.

Results: The mean Rowe score was 94.3 for the affected shoulder and 96.8 for the uninjured side. The Constant score reached 93.5 and 95 points, respectively. Loss of external rotation was 4.36° in adduction and 3.19° at 90° of abduction. The computed tomography evaluation included 24 shoulders at a mean follow-up of 106.2 months. There were no recurrences of instability and 1 traumatic graft fracture. Of the 19 patients in whom arthropathy was present at follow-up, 11 had arthrosis before surgery.

Conclusion: The J-bone graft is capable of creating a stable shoulder joint without causing extensive loss of motion on the long term in patients with traumatic glenoid rim fractures after shoulder dislocation. In some patients, mild to moderate arthropathy develops despite anatomical glenoid reconstruction.

Key Words: shoulder dislocation • glenoid rim defect • bone grafting • J-bone graft