Achraf Oueslati, Abderrazzek Rafrafi, Talel Znagui, Saber Saadi, Lotfi Nouisri
Service d´Orthopédie et de Traumatologie, Hôpital Militaire Principale d´Instruction de Tunis, Montfleury, Tunis, Tunisie.
Pan Afr Med J. 2021 Feb 24;38:215. doi: 10.11604/pamj.2021.38.215.21339. eCollection 2021.
Anterior shoulder instability following traumatic dislocation in young adults is a common complication. The Latarjet procedure is the most widely used technique for treating this instability. It is based on coracoid abutment repair of the anterior edge of the glenoid. However, joint exposure during this surgical technique is often limited and makes it difficult to position the abutment. The purpose of this study was to evaluate the result of coracoid abutment procedure on functional outcome in the short and medium term. We assessed the positioning of the coracoid abutment on standard postoperative X-rays and the functional outcome according to Duplay score as well as the satisfaction rate in 70 patients. The average age of patients was 25 and a half years, the sex-ratio was nine, and the mean follow-up period was 6.5 years. Radiological examination showed that coracoid abutment was in subequatorial or non-flush position with respect to the anterior glenoid rim (too internal or protruding in intra-articular position) in 20% of cases. This group showed a drop in mean stability score by 7.68 points, in pain by 10.04 points and in Duplay's overall score by 13.3 points as well as a significant increase in the level of glenohumeral arthrosis. This study highlights that coracoid abutment in subequatorial or non-flush position has deleterious effect on the functional outcome of the Latarjet procedure.
年轻成人创伤性脱位后出现的肩关节前不稳定是一种常见并发症。Latarjet手术是治疗这种不稳定最广泛使用的技术。它基于肩胛盂前缘的喙突对接修复。然而，这种手术技术过程中的关节暴露往往有限，使得对接的定位变得困难。本研究的目的是评估喙突对接手术在短期和中期对功能结局的影响。我们在标准术后X线片上评估喙突对接的定位，并根据Duplay评分评估功能结局以及70例患者的满意率。患者的平均年龄为25.5岁，性别比为9，平均随访期为6.5年。影像学检查显示，20%的病例中，喙突对接相对于肩胛盂前缘处于赤道下或不平整位置（过于靠内或在关节内位置突出）。该组患者的平均稳定性评分下降7.68分，疼痛评分下降10.04分，Duplay总分下降13.3分，并且盂肱关节骨关节炎水平显著增加。本研究强调，赤道下或不平整位置的喙突对接对Latarjet手术的功能结局有有害影响。
