Filho Jaime Guiotti, Leite Marcelo Carvalho, Borges Antônio Carlos Wall, de Souza Gabriel Terra, do Prado Otaniel Figueiredo
Serviço de Ombro e Cotovelo, Instituto Ortopédico de Goiânia, Goiânia, GO, Brasil.
Rev Bras Ortop (Sao Paulo). 2020 Aug;55(4):455-462. doi: 10.1055/s-0039-3402455. Epub 2020 Apr 6.
To verify the results of 27 patients submitted to surgery from 1990 to 1997 by the Bristow-Latarjet technique for the treatment of anterior traumatic instability of the shoulder. The analysis included the possible complications, especially the appearance of arthropathy. The subjective clinical evaluation was performed through a questionnaire answered by the patients, and the objective evaluation was performed using the Rowe et al score. The radiographic evaluation was performed using the anteroposterior (true) incidence to detect signs of shoulder arthrosis, according to the classification of Samilson and Prieto, as well as the apical oblique and the Bernageau and Patte incidences to verify the consolidation of the bone graft, the position of the screw and of the graft, and signs of the release of the synthesis material. These evaluations were performed by two examiners at different times without interference between them. In the subjective assessment of the patients, 93% were fully recovered, and, in the objective evaluation, the average was 95 points on the Rowe et al score. Complications related to coracoid placement were not found. The degree of arthropathy of the shoulders, according to the Samilson and Prieto classification, presented an average of seven mild cases, two moderate cases and one severe case. In total, 17 patients did not present arthropathy. Between the first and second evaluations, there was no change in the efficacy of the Bristow-Latarjet technique. The careful observation of the criteria of the technique was fundamental to avoid complications. The occurrence of arthropathy in the long term was not relevant in our evaluation. Based on the evidences of the present study, the surgical procedure alone is not the cause of the onset of the arthropathy, but the failure in its execution.
为验证1990年至1997年期间采用布里斯托-拉塔热技术对27例肩部前创伤性不稳定患者进行手术的结果。分析内容包括可能出现的并发症，尤其是关节病的出现情况。
主观临床评估通过患者填写的问卷进行，客观评估采用罗伊等人的评分标准。根据萨米尔森和普列托的分类，使用前后位（真实）投照来检测肩关节病的迹象进行影像学评估，同时使用顶斜位以及贝纳热和帕特投照来验证骨移植的愈合情况、螺钉和移植骨的位置以及合成材料的松动迹象。这些评估由两名检查人员在不同时间进行，彼此之间互不干扰。
在患者的主观评估中，93%的患者完全康复，在客观评估中，罗伊等人评分的平均分为95分。未发现与喙突放置相关的并发症。根据萨米尔森和普列托分类，肩部关节病的程度平均为7例轻度、2例中度和1例重度。总共有17例患者未出现关节病。
在第一次和第二次评估之间，布里斯托-拉塔热技术的疗效没有变化。严格遵循该技术的标准对于避免并发症至关重要。在我们的评估中，长期关节病的发生并无关联。基于本研究的证据，单纯的手术操作并非关节病发病的原因，而是手术执行过程中的失误所致。
