Improvement in Drilling Instruments for the Coracoid Process.

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We developed a drilling instrument (Type 1) for the coracoid process two years ago, and have been performing a modified Boytchev's procedure for patients with recurrent shoulder disloction using this instrument.When we inserted a screw into the coracoid process using the Type 1 instrument, the axis of the screw was directed caudally toward the coracoid process. We have now developed a new drilling instrument for the coracoid process (Type 2) that is able to insert the screw correctly into the center of the coracoid process. We performed a comparative study concerned with direction of the screw for three groups. Group 1: 13 cases had a screw inserted without intstrumentation. Group 2: 14 cases had their screw inserted using the Type 1 instrument. Grupe 3: Five cases had their screw inserted using the Type 2 instrument. Angles of inserted screw toward the coracoid process were compared in each group and were measured in antero-postero views, scapular outlet views and axial views by plain X-ray after the modified Boytchev procedure. The angles of Group 1 revealed a larger deviation than one of Group 1 and Group 2. The angles of Group 2 and Group 3 were less than the one of Group 1 in A-P views and Y-views. Using the improved drilling instrument for the coracoid process (Type 2), a hole can be easily made in the center of the coracoid process.The Type 2 instrument is available for various shoulder operations, for example, Bankart's procedure, capsular shift, Dewar's procedure, Bristow's procedure and total replacement of the shoulder joint.
西日本整形・災害外科学会の論文

Improvement in Drilling Instruments for the Coracoid Process.

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