Screws and staples are used frequently in the surgical treatment of glenohumeral joint problems. We analyzed a series of 37 patients with complications related to the use of these implants. 21 patients had problems related to the use of screws for affixing a transferred coracoid process to the glenoid. 16 patients had problems related to the use of staples: 10 had undergone capsulorrhaphy, 4 had had advancement of the subscapularis, and 2 had had repair of a rotator cuff tear. The complaints at examination were shoulder pain (36 patients), decreased glenohumeral motion (19 patients), crepitus with glenohumeral motion (16 patients), and radiating paresthesias (4 patients). The time between placement of the implant and the onset of symptoms ranged from 4 weeks to 10 years. The screws or staples had been incorrectly placed in 10 patients, had migrated or loosened in 24, and had fractured in 3. 34 patients required a second surgical procedure specifically for removal of the implant. At operation 14 patients (41 per cent) were noted to have sustained a significant injury to the articular surface of the glenoid or humerus. The results in this group of patients indicated that screws and staples can produce complications that require reoperation and are capable of causing a permanent loss of joint function. Adequate surgical exposure and careful placement of the implant appear to be essential when these devices are used about the glenohumeral joint.
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Screws and staples are used frequently in the surgical treatment of glenohumeral joint problems. We analyzed a series of 37 patients with complications related to the use of these implants. 21 patients had problems related to the use of screws for affixing a transferred coracoid process to the glenoid. 16 patients had problems related to the use of staples: 10 had undergone capsulorrhaphy, 4 had had advancement of the subscapularis, and 2 had had repair of a rotator cuff tear. The complaints at examination were shoulder pain (36 patients), decreased glenohumeral motion (19 patients), crepitus with glenohumeral motion (16 patients), and radiating paresthesias (4 patients). The time between placement of the implant and the onset of symptoms ranged from 4 weeks to 10 years. The screws or staples had been incorrectly placed in 10 patients, had migrated or loosened in 24, and had fractured in 3. 34 patients required a second surgical procedure specifically for removal of the implant. At operation 14 patients (41 per cent) were noted to have sustained a significant injury to the articular surface of the glenoid or humerus. The results in this group of patients indicated that screws and staples can produce complications that require reoperation and are capable of causing a permanent loss of joint function. Adequate surgical exposure and careful placement of the implant appear to be essential when these devices are used about the glenohumeral joint.
Copyright remains with the authors and publisher.