Anterior Reconstruction

  • Stephen J. Lombardo
Part of the Comprehensive Manuals of Surgical Specialties book series (CMSS)


The Bristow procedure, in which the distal portion of the coracoid process is sutured to the anterior aspect of the scapular neck through a transversely sectioned subscapularis muscle, was described in 19583 for anterior instability of the shoulder. Mead5 modified that procedure by affixing the bone block to the anterior glenoid rim with a screw. In recent years, this modified Bristow procedure has gained in popularity. Since 1971, over 500 procedures have been performed in our office for recurrent anterior shoulder subluxation/dislocation. The procedure has proved to be effective with an approximate recurrence rate of 2 to 3 percent.1,2,4 It has not, however, permitted athletes who are engaged in sports that feature throwing as an activity to return to their preinjury functional level. Other procedures used in this select group of athletes have likewise been unrewarding to date.


Humeral Head Drill Hole Bone Block Shoulder Instability Coracoid Process 
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  1. 1.
    Barry TP, Lombardo SJ, et al: The coracoid transfer for recurrent anterior instability of the shoulder in adolescents. J Bone Jt Surg 1985;67A:383–387.Google Scholar
  2. 2.
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  3. 3.
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Additional Reading

  1. Chen SK, Perry J, et al: Elbow flexion analysis in Bristow patients. A preliminary report. Am J Sports Med 1984;12:347–350.PubMedCrossRefGoogle Scholar
  2. Hill J A, Lombardo SJ, et al: The modified Bristow-Helfet procedure for recurrent anterior shoulder subluxations and dislocations. Am J Sports Med 1981;9:283–287.PubMedCrossRefGoogle Scholar
  3. Mizuno K, Hirohata K: Diagnosis of recurrent traumatic anterior subluxation of the shoulder. Clin Orthop 1983;179:160–167.PubMedGoogle Scholar
  4. Pappas AM, Goss TP, Kleinman PK. Symptomatic shoulder instability due to lesions of the glenoid labrum. Am J Sports Med 1983;11:279–288.PubMedCrossRefGoogle Scholar
  5. Rowe CR, Zarins B, Cuillo JV: Recurrent anterior dislocation of the shoulder after surgical repair. J Bone Jt Surg 1984;66A: 159–168.Google Scholar
  6. Warren RF: Subluxation of the shoulder in athletes. Clin Sports Med 1983;2:339–354.PubMedGoogle Scholar
  7. Zarins B, Rowe CR: Current concepts in the diagnosis and treatment of shoulder instability in athletes. Med Sci Sports Exerc 1984;16(5):444–448.PubMedCrossRefGoogle Scholar
  8. Zuckerman JD, Matsen FA: Complications about the glenohumeral joint related to the use of screws and staples. J Bone Jt Surg 1984;66A:175–180.Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1987

Authors and Affiliations

  • Stephen J. Lombardo

There are no affiliations available

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