- Discussion: - indicated for irreparable injury to the subscapularis which is causing recurrent instability;
- Anterior Approach to the Shoulder:
- Release of Superior Pectoral Tendon: - superior 2.5-3 cm of the pectoralis tendon is released off the humerus; - stay sutures are inserted into the tendon edge; - tension is placed on the stay sutures, and the tendon is dissected medially for 10 cm, or a sufficient distance to allow it to be mobilized to the insertion site of the subscapularis; - the insertion site of the scapularis is freshened down to a bleeding surface; - the tendon is placed under tension, and the optimal position for anchor placement is determined; - 3 or 4 biologically quiet screws are inserted into this bed;
- the tendon is then anchored down; ------------------------------- Operative Treatment of Irreparable Rupture of the Subscapularis. M.A. Wirth MD and C.A. Rockwookd Jr. MD JBJS Vol 79-A. No. 5, May 1997. p. 722-731.
