Capsular Shifting Procedure with Cruciate Repair for Recurrent Anterior Shoulder Dislocation - A Preliminary Report

The shallowness of the glenoid fossa makes the shoulder inherently unstable. The glenoid labrum serves to deepen the shallow cup of the bony glenoid and increases the contact area between the glenoid and humeral head. An injured labrum, a lax or ballooned capsule and Bankart lesion were the frequent surgical findings in recurrent anterior shoulder dislocation. From April, 1986 to January, 1987, we used double contrast CT arthro-graphy for 10 patients with recurrent anterior shoulder dislocation a detect and correlate the surgical lesions accurately. The main pathological findings were capsular laxity and redundancy, various types of labrum injury including blunting, attenuation, Bucket-handle tear (n=3) or even loss of the anterior labrum (n=3). Bankart lesion in anterosuperior (n=4) or anteroinferior (n=6) portion including stripping, stretching of the capsule (n=9) or even avulsion fracture of the glenoid (n=1) were found. There were many kinds of reconstruction method for the recurrent anterior shoulder dislocation in the literature, we reconstructed the lesions with a modified Bankart procedure based on the concept of capsular shift of Neer in 1980. The logical rationale and merits of the treatment will be presented and discussed.