Shively J, Johnson J
Clin Orthop Relat Res. 1984 Jul-Aug(187):150-3.
A modified Bristow procedure was performed on 23 patients over a two-year period. The modification consisted of splitting the subscapularis muscle in line with its fibers and attaching the coracoid process to the neck of the scapula with a malleolar screw. The results were evaluated by questionnaire, physical examination, and radiographs. The average age of the patients was 24 years. There were 20 men and three women. The patients presented 16 left shoulders and seven right shoulders; nine were dominant. The number of previous dislocations was 12. The average follow-up period was 25 months and the average hospital stay was two days. There were no blood transfusions. Each patient returned to his or her preoperative activity level; no patient had pain in the shoulder at rest. With overhead activity, five patients had some pain and 18 had none. Of the nine patients whose surgery was on the dominant side, only two had difficulty in throwing. There were no postoperative recurrent dislocations. There was an average loss of external rotation of 13 degrees and an average loss of internal rotation of 12 degrees. Bony fusion of the coracoid to the neck of the scapula occurred in only one out of 13 shoulders. Complications were minor and resolved completely. The advantages of the procedure are good surgical exposure, minimal tissue trauma, insignificant blood loss, and fewer days in the hospital per patient. The procedure was relatively safe and generally effective.
在两年时间里，对23例患者实施了改良布里斯托手术。改良之处包括沿肩胛下肌纤维方向劈开该肌肉，并用踝螺钉将喙突固定于肩胛骨颈部。通过问卷调查、体格检查和X线片对结果进行评估。患者的平均年龄为24岁。其中男性20例，女性3例。患者中16例为左肩，7例为右肩；9例为优势肩。既往脱位次数为12次。平均随访期为25个月，平均住院时间为2天。无输血情况。每位患者均恢复至术前活动水平；无患者在静息时肩部疼痛。进行过头活动时，5例患者有一些疼痛，18例无疼痛。在9例手术位于优势侧的患者中，只有2例在投掷时有困难。无术后复发性脱位。平均外旋丧失13度，平均内旋丧失12度。在13例肩部中，只有1例出现喙突与肩胛骨颈部的骨性融合。并发症轻微且完全缓解。该手术的优点是手术暴露良好、组织创伤最小、失血量少以及每位患者的住院天数少。该手术相对安全且总体有效。
