Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability

Introduction: The glenohumeral joint is one with the greatest mobility and intimate contact between the articular surfaces of the humeral head and glenoid labrum contributes to its stability. Patients with recurrent dislocations have bone deficits in one or both of these surfaces, due to the presenc...

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Main Authors: Tengku Mohamed Shihabudin, Tengku Muzaffar, Sharifudin, Mohd Ariff, Mohamed Muslim, Darhaysham Al Jefri
Format: Article
Language:English
English
English
Published: Malaysian Orthopaedic Association 2012
Subjects:
Online Access:http://irep.iium.edu.my/29416/
http://irep.iium.edu.my/29416/
http://irep.iium.edu.my/29416/1/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Cover%29.pdf
http://irep.iium.edu.my/29416/2/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Content_Page_59-67%29.pdf
http://irep.iium.edu.my/29416/3/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Scanned_pg_109%29.pdf
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spelling iium-294162013-03-07T06:15:04Z http://irep.iium.edu.my/29416/ Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability Tengku Mohamed Shihabudin, Tengku Muzaffar Sharifudin, Mohd Ariff Mohamed Muslim, Darhaysham Al Jefri RC1200 Sports Medicine RD701 Orthopedics RZ301 Osteopathy Introduction: The glenohumeral joint is one with the greatest mobility and intimate contact between the articular surfaces of the humeral head and glenoid labrum contributes to its stability. Patients with recurrent dislocations have bone deficits in one or both of these surfaces, due to the presence of a Bankart lesion or an engaging Hill-Sachs lesion. Although successful arthroscopic management of instability associated with osseous defects is an alternative, open reconstruction is often indicated. Large osseous defects can be challenging and preclude arthroscopic treatment. Case Report: A 30-year-old man with a history of chronic, recurrent left shoulder dislocation for more than 10 years was referred to us for further evaluation and treatment. Our assessment revealed a large Bankart lesion combined with a large Hill Sach lesion over the humeral head. Open reduction with bone augmentation of the glenoid osseous defect was performed using autogenous bone graft from the iliac crest. Intraoperative assessment showed adequate stability for the humeral head defect without the need for intervention. The technical aspect of the surgery is described together with the clinical outcomes of the patient. Discussion/Conclusion: An estimated osseous defect with a width of 20% of the glenoid length remains unstable and requires bone augmentation. Bone grafting was the stabilizing mechanism in the restoration of the glenoid concavity. Most patients with bone deficits on both articular surfaces can suitably be treated by reconstructing only one of the deficits, but occasionally both defects may require intervention. To date, there are no validated preoperative guidelines for cases when both procedures are required. An intra-operative assessment remains our best tool. Malaysian Orthopaedic Association 2012-06-17 Article PeerReviewed application/pdf en http://irep.iium.edu.my/29416/1/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Cover%29.pdf application/pdf en http://irep.iium.edu.my/29416/2/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Content_Page_59-67%29.pdf application/pdf en http://irep.iium.edu.my/29416/3/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Scanned_pg_109%29.pdf Tengku Mohamed Shihabudin, Tengku Muzaffar and Sharifudin, Mohd Ariff and Mohamed Muslim, Darhaysham Al Jefri (2012) Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability. Malaysian Orthopaedic Journal, 6 (2sup.A). p. 109. ISSN 1985-2533 http://www.morthoj.org/
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
English
English
topic RC1200 Sports Medicine
RD701 Orthopedics
RZ301 Osteopathy
spellingShingle RC1200 Sports Medicine
RD701 Orthopedics
RZ301 Osteopathy
Tengku Mohamed Shihabudin, Tengku Muzaffar
Sharifudin, Mohd Ariff
Mohamed Muslim, Darhaysham Al Jefri
Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
description Introduction: The glenohumeral joint is one with the greatest mobility and intimate contact between the articular surfaces of the humeral head and glenoid labrum contributes to its stability. Patients with recurrent dislocations have bone deficits in one or both of these surfaces, due to the presence of a Bankart lesion or an engaging Hill-Sachs lesion. Although successful arthroscopic management of instability associated with osseous defects is an alternative, open reconstruction is often indicated. Large osseous defects can be challenging and preclude arthroscopic treatment. Case Report: A 30-year-old man with a history of chronic, recurrent left shoulder dislocation for more than 10 years was referred to us for further evaluation and treatment. Our assessment revealed a large Bankart lesion combined with a large Hill Sach lesion over the humeral head. Open reduction with bone augmentation of the glenoid osseous defect was performed using autogenous bone graft from the iliac crest. Intraoperative assessment showed adequate stability for the humeral head defect without the need for intervention. The technical aspect of the surgery is described together with the clinical outcomes of the patient. Discussion/Conclusion: An estimated osseous defect with a width of 20% of the glenoid length remains unstable and requires bone augmentation. Bone grafting was the stabilizing mechanism in the restoration of the glenoid concavity. Most patients with bone deficits on both articular surfaces can suitably be treated by reconstructing only one of the deficits, but occasionally both defects may require intervention. To date, there are no validated preoperative guidelines for cases when both procedures are required. An intra-operative assessment remains our best tool.
format Article
author Tengku Mohamed Shihabudin, Tengku Muzaffar
Sharifudin, Mohd Ariff
Mohamed Muslim, Darhaysham Al Jefri
author_facet Tengku Mohamed Shihabudin, Tengku Muzaffar
Sharifudin, Mohd Ariff
Mohamed Muslim, Darhaysham Al Jefri
author_sort Tengku Mohamed Shihabudin, Tengku Muzaffar
title Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
title_short Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
title_full Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
title_fullStr Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
title_full_unstemmed Open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
title_sort open bone augmentation for large osseous defects in chronic, recurrent glenohumeral instability
publisher Malaysian Orthopaedic Association
publishDate 2012
url http://irep.iium.edu.my/29416/
http://irep.iium.edu.my/29416/
http://irep.iium.edu.my/29416/1/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Cover%29.pdf
http://irep.iium.edu.my/29416/2/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Content_Page_59-67%29.pdf
http://irep.iium.edu.my/29416/3/Malaysian_Orthopaedic_Journal_-_2012%2C_Volume_6%2C_Issue_2._Supplement_A._%28Scanned_pg_109%29.pdf
first_indexed 2023-09-18T20:43:11Z
last_indexed 2023-09-18T20:43:11Z
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