Abstract
Literature on anterior shoulder instability deals most often with elimination of recurrence following recon struction. We analyzed the subjective function, loss of motion and shoulder strength of three operative pro cedures : Magnuson-Stack, Bristow, and Putti-Platt. A retrospective review of 27 patients, 9 in each surgical group, with no postoperative dislocations or on-going pain was performed. All patients were male, right hand dominant with the right shoulder affected. Average time of followup was 6.75 years (range, 4.2 to 10.3 years). All patients completed a questionnaire and had their range of motion measured by a hand-held goniometer and their shoulder strength tested on the Cybex II Dynomometer. Peak torque as a percent of body weight and side-to-side differences were calculated for six arm positions and compared to nine right hand dominant controls of similar age and recreational activ ity.
Sixty percent returned to throwing sport. One Mag nuson-Stack and Bristow patient felt full functional re turn to preinjury level. Three patients in each of these two groups returned to unmodified throwing sport whereas no Putti-Platt patient attained this level. Deficit of external rotation at shoulder neutral measured 4.7°, Magnuson-Stack; 12.2°, Bristow; and 21.8°, Putti- Platt. At 90° shoulder abduction, similar deficits in external rotation measured 6.4°, 11.6°, and 28.8° re spectively. These values were statistically significant employing analysis of variance.
We compared the operative groups as a whole to the controls and compared the operative groups to each other. Statistically significant weakness was found in external rotation of all patients as opposed to control subjects at shoulder 90° abduction and neutral position (P < 0.05). No flexion weakness was found in the Bristow group. We have concluded that functional re turn to throwing sport favors the Magnuson-Stack and Bristow patients over the Putti-Platt. Statistically signif icant differences of external rotation loss exists at shoulder 90° abduction. The operative group was sta tistically significantly weaker than controls in external rotation at shoulder neutral and 90° abduction. Also, there was no relative weakness between groups.
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