The Magnuson-Stack procedure for treatment of recurrent glenohumeral dislocations

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Abstract
The Magnuson-Stack procedure was developed in 1943 as a treatment for recurrent anterior dislocation of the glenohumeral joint. Since that time, very little literature has been published on this procedure. The purpose of our study is to evaluate its efficacy in preventing further dislocations and, also, introduce the Cybex Isokinetic Dynamometer as a quantitative tool in scientifically evaluating total shoulder function. At the Bryn Mawr (Pennsylvania) Hospital from 1971 to 1978, 43 patients underwent a Magnuson-Stack procedure. Twenty-nine returned detailed question naires ; 26 of these patients returned for clinical and roentgenographic examination by one of the authors, and 18 had their shoulder motion and power quantita tively compared to their contralateral normal arms with the Cybex Isokinetic Dynamometer. Eighty-five percent of shoulders did not dislocate postoperatively; 90% considered their results satisfac tory. By gross physical examination, no shoulder atro phy was noted. Strength seemed to equal the uninjured shoulder. Range of motion showed a 10° loss of exter nal rotation as measured with a hand-held goniometer. However, by testing range of motion with the Cybex system, a 25° lack of external rotation was noted. Force values measured at 60° of arc/sec and 180° of arc/sec showed an 18 and 10% deficit, respectively, in external rotation. The authors believe that the Magnuson-Stack pro cedure has a place in the treatment of recurrent anterior dislocations of the shoulder. Also, the Cybex II isolated joint testing system provides an accurate reproducible method of comparing the postoperative results of all patients treated for dislocation of the shoulder. Hope fully, from such data, information can be obtained which will be valuable in selecting the appropriate operative procedure for each individual's needs as well as assist ing in the development of postoperative rehabilitation programs designed to maximize shoulder function while minimizing disability time.