A Prospective Study Showing Functional Outcome of the Modified Boytchev Procedure for Recurrent Anterior Shoulder Dislocation.

INTRODUCTION

Shoulder dislocation following trauma is associated with high rates of recurrence. Numerous surgical techniques, although effective, often reduce the shoulder's range of motion. The Modified Boytchev procedure has emerged as a preferred method for treating recurrent anterior shoulder dislocation.

MATERIALS AND

METHODS

This prospective observational study was conducted between August 2022 and February 2024 in the Department of Orthopaedics at a tertiary hospital. Thirty patients with recurrent anterior dislocations were enrolled and treated using the Modified Boytchev procedure. The Oxford Shoulder Instability Score and the Burkhead and Rockwood criteria were used for post-operative evaluation.

DISCUSSION: The shoulder joint is a ball-and-socket type of joint, giving it the greatest mobility in the whole body. This is due to its supporting structures and stabilizers, including bony anatomy and soft tissues, which provide flexibility and stability. The anatomy of this joint is redundant inferiorly, due to which it commonly dislocates antero-inferiorly. The aim of any surgical technique is to stabilize the damaged portion (i.e., antero-inferiorly or bony support) to reduce recurrences. Despite new procedures and skills, this old technique, being an open technique of stabilisation, has shown good results in terms of reduced recurrences, infection rate, good post-operative mobility and returning to their daily activities.

RESULTS

The mean follow-up period was 18 months. Outcomes were excellent in 20 patients, good in 6, fair in 2, and poor in 2. Shoulder stability improved with increased range of motion in all directions. Minimal external rotation deficits were observed.

CONCLUSION

The Modified Boytchev procedure meets most criteria for an ideal surgical technique, achieving excellent functional results in managing recurrent anterior shoulder dislocation.