Description
A team of orthopedic surgeons, introduced in Portugal the Verma System in the treatment of shoulder instability through the Latarjet technique.
Introduction
Shoulder instability is a common nomological entity of congenital or traumatic nature. It reaches 1,7% of the general population, frequently amongst individuals under the age of 30 and athletes that practice contact sports football, wrestling, ice hockey and rugby).
The treatment of shoulder instability by the Latarjet Technique dates from the 1950s, developed by the French surgeon Dr. Michel Latarjet in 1954 to treat recurrent dislocation of the shoulder with bone loss or glenoid fracture. It was further developed by the English surgeon Bristow, (it was Helfet's disciple of Bristow who described this technique in 1958) and has since become known for the Bristow-Latarjet technique.
The surgical stabilization is indicated if conservative treatment fails or when there are associated injuries, namely glenoid associated fractures.
Methods
The success of this technique is based on the Latarjet triple effect; Bone block, Belt or sling effect, Capsule repair.
However, the Latarjet technique is not harmless. In addition to its technical difficulty, complications are mentioned: poorly positioned graft, bone graft fracture, graft pseudarthrosis that occur between 3% to 14%, glenohumeral arthrosis, cutaneous muscle nerve injury, subscapular tendon dysfunction.
These complications led to the development of a system to be minimized or eliminated.
This system has the following changes: Specific retractors, Specific coracoid preparation guide, Offset guide.
The elected approach is the Delto-pectoral with an incision about 6 cm to expose the coracoid.
Conclusion
Verma’s biggest gain is the minimally invasive approach implementation of the Latarjet technique through the innovative instrumental.
Paula Helena Ferreira da Silva
Advanced Medical Studies
Orthopaedic Consultant
Chief Department of Shoulder and Elbow unit of CUF Coimbra Hospital
Member of ESSKA
Member of EHS
Member of SPOC
