THE RESULTS OF SURGICAL TREATMENT FOR SHOULDER INSTABILITY ACCOMPANIED BY HILL-SACHS LESIONS
Prof. M. I. Sytenko Institute of Spine and Joint Pathology, NAMS of Ukraine, Kharkiv, Ukraine
According to Ukrainian and foreign authors, the percentage of recurrence after reconstructive surgery for shoulder instability with Hill−Sachs lesion is 2.8−30 %. The purpose of the work was to analyze the results of surgical treatment of patients with shoulder instability accompanied by Hill−Sachs lesion. The results of treatment of 63 (53 men, 84.1 % and 10 women, 15.9 %) patients of working age (16−63 years old) with traumatic anterior instability of the shoulder joint with Hill−Sachs lesion, who were treated in hospital at Prof. M.I. Sytenko Institute of Spine and Joint Pathology (National Academy of Medical Science of Ukraine) within the period from 2009 to 2014 were analyzed. Sixty−four shoulder joints were operated, of them 38 right (59.4 %), 26 left (40.6 %), one patient was operated on the both shoulder joints. All patients were divided into three groups according to the defect volume and therefore the type of surgery performed. The comparison group consisted of patients with subcapital torsion humeral osteotomy, operated before 2009 with similar damage, excluding the value of the defect. The results of treatment were estimated as 90−100 points (excellent result) while in patients who underwent torsion subcapital osteotomy the results did not exceed 80 points within a period of 6 months follow−up (60 ? 80 points) and a year later reached the level of 65 to 85 points and were assessed as satisfactory. In group 4 recurrent dislocation of the humerus within the period of 6 months and 1 year after the surgery were not recorded, as the patients did not complain of pain. The type of surgery depends on the defect volume. Determining the defect of the humeral head can more accurately determine the volume of surgical treatment for each patient. Poor results of treatment in group 4 are mainly due to the presence of restriction of movement in the shoulder joint, largely due to abduction and external rotation.
Key words: shoulder joint instability, Hill−Sachs injury, treatment outcome.