A STUDY OF MANAGEMENT OF RECURRENT ANTERIOR DISLOCATION SHOULDER BY MODIFIED BOYTCHEV PROCEDURE

Recurrent dislocation of shoulder limits the activity of the shoulder and impairs the functional efficiency of the modern man. So far more than 150 surgical procedures were described for the treatment of recurrent dislocation of shoulder. There is no gold standard among them with each having its own advantages and disadvantages. In modified Boytchev procedure, the osteotomised and detached tip of coracoid process with its conjoint tendon attachment is rerouted deep to the subscapularis muscle, and reattached to its original anatomical location. The conjoint tendon with short head of biceps and coracobrachialis in its transferred position produces a strong dynamic buttress effect across the anterior and inferior aspects of the shoulder, when the joint is in the vulnerable position of abduction and external rotation. This is the key for the success of this procedure. Our study evaluates the results of the procedure performed at our institute in 23 subjects during the period of 2002-March 2015. We achieved good to excellent results in 87% of the cases who regained almost full range of motion. One case was noted to have screw loosening on follow up and one case developed shoulder stiffness due to improper physiotherapy. In conclusion, Modified Boytchev procedure is an effective and a simple procedure to perform, in the management of recurrent dislocation of shoulder.