Role of the coracoid bone block in the modified Bristow procedure.

In 20 shoulders (19 patients) with a Bankart lesion, the isolated coracoid process was transferred as a bone graft to the anterior rim of the glenoid. The graft was positioned directly at the site of the Bankart lesion without displacing the insertion of the conjoined tendon or subscapularis. The average age of the patients was 22.5 years (range, 15 to 42). Follow-up examination at a minimum of 3 years (average, 55 months) showed 17 of 20 shoulders (85%) presented with good or excellent results. One recurrent dislocation was noted. There were no complications related to screw fixation of the coracoid process. External rotation loss of the operated arm in 90 degrees of abduction averaged only 5 degrees. Ten of 12 patients (83%) with an operation on the dominant shoulder returned to throwing sports and overhead motion activities. However, a 15% fair or poor rate suggests that this procedure may control dislocation, but that subluxation is not as well controlled.