[Functional outcome of Eden-Hybinette-Lange operation in post-traumatic recurrent shoulder dislocation]. / Funktionelle Ergebnisse nach Eden-Hybinette-Lange-Operation bei posttraumatisch rezidivierender Schulterluxation.

OBJECTIVE: Post-traumatic recurrent dislocation is a major problem in the operative treatment of shoulder dysfunction in young athletes. This prospectively designed study evaluates the long-term results of a modified Eden-Hybinette procedure in young male athletes. The criteria were: capacity in sports, functional limit, and persistent pain. Genuine disorders of the glenoid or muscular imbalance of the shoulder joint were criteria for exclusion. PATIENTS AND METHODS: From 1982 to 1990, 143 patients underwent surgery. Seventy percent were reevaluated within a minimum period of 18 months after the operation. The functional results were calculated using the ROWE score as well as a visual analog scale (VAS). X-rays were done after the patient had given informed consent. RESULTS: VAS and ROWE score showed excellent/good results in 61%, fair results in 18%, and poor results in 21% of the documented cases. The rate of arthrosis was 25%. Redislocation occurred in 7%, mainly without any relevant trauma. The X-rays showed complete resorption of the bone graft in 30% of the cases. Best functional results and no redislocation were found in the patients who underwent surgery with fewer than 3 dislocations compared to those with more than 4 dislocation episodes. CONCLUSIONS: In cases of post-traumatic recurrent dislocation of the shoulder in young athletes, the modified Eden-Hybinette procedure is a good method of reestablishing sufficient stability of the shoulder. The operation should be performed prior to the 3rd dislocation episode. Four or more dislocation episodes show an increased tendency to redislocate and poor functional results.

[Preoperative autologous blood donation in thoracic surgery]. / Die präoperative Eigenblutspende in der Thoraxchirurgie.

The donation by the patient of two units of his own blood shortly before (on average on the 9th and 7th day) scheduled major surgery on the chest is feasible in 70 to 80% of patients. In our group (n = 170) it resulted in a highly significant reduction in the use of banked blood units: a 76% reduction vis-a-vis the number of units transfused in a group operated on in the previous year and comprising comparable patients receiving comparable procedures, in whom no autologous blood was administered. The procedure is cost-effective.