Between 1980 and 1994, 221 shoulders with recurrent anterior glenohumeral subluxation or dislocation were reconstructed at our institution. At the time of the operation, 13 shoulders were found to have an irreparable injury of the subscapularis muscle, which we believed to be a contributing factor to the ongoing instability. All but 3 of the 13 patients had had 2 to 6 previous reconstructions. Operative treatment of the irreparable rupture included a dynamic muscle transfer using the pectoralis major in 7 shoulders, the pectoralis minor in 5, and both of these muscles in one. According to a modification of the grading system of Neer and Foster, the result was satisfactory for 10 shoulders and unsatisfactory for 3 at a mean of 5 years after the operation. All shoulders with a satisfactory result demonstrated active contraction of the transferred pectoralis muscle and diminished anterior glenohumeral translation. On the basis of our analysis, we concluded that transfer of the pectoralis muscle is effective for reconstruction of the shoulder in patients who have loss of the subscapularis muscle.
Copyright remains with the authors and publisher.
Between 1980 and 1994, 221 shoulders with recurrent anterior glenohumeral subluxation or dislocation were reconstructed at our institution. At the time of the operation, 13 shoulders were found to have an irreparable injury of the subscapularis muscle, which we believed to be a contributing factor to the ongoing instability. All but 3 of the 13 patients had had 2 to 6 previous reconstructions. Operative treatment of the irreparable rupture included a dynamic muscle transfer using the pectoralis major in 7 shoulders, the pectoralis minor in 5, and both of these muscles in one. According to a modification of the grading system of Neer and Foster, the result was satisfactory for 10 shoulders and unsatisfactory for 3 at a mean of 5 years after the operation. All shoulders with a satisfactory result demonstrated active contraction of the transferred pectoralis muscle and diminished anterior glenohumeral translation. On the basis of our analysis, we concluded that transfer of the pectoralis muscle is effective for reconstruction of the shoulder in patients who have loss of the subscapularis muscle.
Copyright remains with the authors and publisher.