Transfer of pectoralis major for the treatment of irreparable tears of subscapularis
Autor: | Bassem T. Elhassan, Mehmet Ugur Ozbaydar, Jon J.P. Warner, David Diller, Laurence D. Higgins, D. Massimini |
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Rok vydání: | 2008 |
Předmět: |
Adult
Joint Instability Male Shoulder medicine.medical_specialty Adolescent Shoulder surgery medicine.medical_treatment Tendon Transfer Pectoralis Muscles Rotator Cuff Injuries Rotator Cuff Tendon transfer medicine Humans Orthopedics and Sports Medicine Rotator cuff Arthroplasty Replacement Range of Motion Articular Subluxation Analysis of Variance Trauma Severity Indices Shoulder Joint business.industry Rotator cuff injury Pectoralis major muscle Recovery of Function Middle Aged medicine.disease Arthroplasty Surgery Treatment Outcome medicine.anatomical_structure Female Shoulder Injuries business Shoulder replacement Follow-Up Studies |
Zdroj: | The Journal of Bone and Joint Surgery. British volume. :1059-1065 |
ISSN: | 2044-5377 0301-620X |
Popis: | Transfer of pectoralis major has evolved as the most favoured option for the management of the difficult problem of irreparable tears of subscapularis. We describe our experience with this technique in 30 patients divided into three groups. Group I comprised 11 patients with a failed procedure for instability of the shoulder, group II included eight with a failed shoulder replacement and group III, 11 with a massive tear of the rotator cuff. All underwent transfer of the sternal head of pectoralis major to restore the function of subscapularis. At the latest follow-up pain had improved in seven of the 11 patients in groups I and III, but in only one of eight in group II. The subjective shoulder score improved in seven patients in group I, in one in group II and in six in group III. The mean Constant score improved from 40.9 points (28 to 50) in group I, 32.9 (17 to 47) in group II and 28.7 (20 to 42) in group III pre-operatively to 60.8 (28 to 89), 41.9 (24 to 73) and 52.3 (24 to 78), respectively. Failure of the tendon transfer was highest in group II and was associated with pre-operative anterior subluxation of the humeral head. We conclude that in patients with irreparable rupture of subscapularis after shoulder replacement there is a high risk of failure of transfer of p?ctoralis major, particularly if there is pre-operative anterior subluxation of the humeral head. |
Databáze: | OpenAIRE |
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