Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES...
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Transcript of Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES...
![Page 1: Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 79(5):722-31.](https://reader031.fdocuments.in/reader031/viewer/2022032517/56649cbf5503460f949852a7/html5/thumbnails/1.jpg)
Operative Treatment of Irreparable Rupture of the Subscapularis*†
by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD
J Bone Joint Surg AmVolume 79(5):722-31
May 1, 1997
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 2: Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 79(5):722-31.](https://reader031.fdocuments.in/reader031/viewer/2022032517/56649cbf5503460f949852a7/html5/thumbnails/2.jpg)
Figs. 1 through 6: Illustrations of the operative procedure.
MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD, JR. J Bone Joint Surg Am 1997;79:722-31
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 79(5):722-31.](https://reader031.fdocuments.in/reader031/viewer/2022032517/56649cbf5503460f949852a7/html5/thumbnails/3.jpg)
Fig. 2 A bone trough is made lateral to the bicipital groove in the distal half of the greater tuberosity.
MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD, JR. J Bone Joint Surg Am 1997;79:722-31
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 79(5):722-31.](https://reader031.fdocuments.in/reader031/viewer/2022032517/56649cbf5503460f949852a7/html5/thumbnails/4.jpg)
Fig. 3 Stay sutures, which had been placed in the pectoralis major, are passed into the bone trough and out through the cortical drill-holes.
MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD, JR. J Bone Joint Surg Am 1997;79:722-31
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 5: Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 79(5):722-31.](https://reader031.fdocuments.in/reader031/viewer/2022032517/56649cbf5503460f949852a7/html5/thumbnails/5.jpg)
Fig. 4 The pectoralis major tendon is transferred lateral to the bicipital groove and is secured into the bone trough.
MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD, JR. J Bone Joint Surg Am 1997;79:722-31
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 6: Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 79(5):722-31.](https://reader031.fdocuments.in/reader031/viewer/2022032517/56649cbf5503460f949852a7/html5/thumbnails/6.jpg)
Fig. 5 An osteotome is used to detach the pectoralis minor tendon, in continuity with the coracoacromial ligament, from the superior aspect of the coracoid.
MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD, JR. J Bone Joint Surg Am 1997;79:722-31
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 7: Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 79(5):722-31.](https://reader031.fdocuments.in/reader031/viewer/2022032517/56649cbf5503460f949852a7/html5/thumbnails/7.jpg)
Fig. 6 The coracoacromial ligament extension of the pectoralis minor tendon is transferred across the bicipital groove and is secured into the bone trough.
MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD, JR. J Bone Joint Surg Am 1997;79:722-31
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 8: Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 79(5):722-31.](https://reader031.fdocuments.in/reader031/viewer/2022032517/56649cbf5503460f949852a7/html5/thumbnails/8.jpg)
Figs. 7-A through 7-D: Photographs of a forty-four-year-old man, made fourteen months after reconstruction of the right shoulder with transfer of the right pectoralis major tendon.
MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD, JR. J Bone Joint Surg Am 1997;79:722-31
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 9: Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 79(5):722-31.](https://reader031.fdocuments.in/reader031/viewer/2022032517/56649cbf5503460f949852a7/html5/thumbnails/9.jpg)
Fig. 7-B Active external rotation and internal rotation of the shoulders.
MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD, JR. J Bone Joint Surg Am 1997;79:722-31
©1997 by The Journal of Bone and Joint Surgery, Inc.
![Page 10: Operative Treatment of Irreparable Rupture of the Subscapularis*† by MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 79(5):722-31.](https://reader031.fdocuments.in/reader031/viewer/2022032517/56649cbf5503460f949852a7/html5/thumbnails/10.jpg)
Fig. 7-D The finding on the lift-off test was normal.
MICHAEL A. WIRTH, and CHARLES A. ROCKWOOD, JR. J Bone Joint Surg Am 1997;79:722-31
©1997 by The Journal of Bone and Joint Surgery, Inc.