Weaver J K, Derkash R S
Department of Orthopaedic Surgery, University of Colorado Health Sciences Center, Denver.
Clin Orthop Relat Res. 1994 Nov(308):102-10.
The authors have been disturbed by a number of reports appearing in the past 5 years condemning the Bristow procedure because of difficulties with screw failure and misplacement, nerve damage, and tethering of the subscapularis. A retrospective study was performed comparing the Bankart and Bristow procedures as performed by the authors during a 10-year period. Complications, rate of recurrence, presence of subluxation, range of motion, return to activity, strength, pain, and overall satisfaction were evaluated. There were 85 patients in the study, of which 61 had the Bristow operation and 24 were treated with the Bankart procedure. The minimum followup was 2 years. Very little difference was found between the 2 operations in any of the parameters studied, and in the authors' opinion, the Bristow procedure remains a reasonable alternative to the Bankart operation. The range of abduction, external rotation, and strength compared favorably with the Bankart group. The authors have encountered instances wherein capsular deficiency rendered the accomplishment of the Bankart procedure difficult or unreliable. Four such cases are reported. Under these circumstances, the Bristow served as a reliable alternative. Technical recommendations for avoiding the difficulties that have led to the condemnation of the Bristow procedure are described in detail.
在过去5年中出现了一些谴责布里斯托手术（Bristow procedure）的报告，这些报告指出该手术存在螺钉失效和位置不当、神经损伤以及肩胛下肌束缚等问题，这让作者们感到不安。作者进行了一项回顾性研究，比较了他们在10年期间实施的Bankart手术和布里斯托手术。对并发症、复发率、半脱位情况、活动范围、恢复活动情况、力量、疼痛和总体满意度进行了评估。该研究中有85名患者，其中61例行布里斯托手术，24例行Bankart手术。最短随访时间为2年。在所研究的任何参数中，两种手术之间几乎没有差异，并且在作者看来，布里斯托手术仍是Bankart手术的合理替代方案。外展、外旋范围和力量与Bankart组相比具有优势。作者遇到过一些情况，即关节囊缺损使得Bankart手术难以完成或不可靠。报告了4例此类病例。在这些情况下，布里斯托手术是一种可靠的替代方案。详细描述了避免导致布里斯托手术受到谴责的困难的技术建议。
