PURPOSE: An osseous defect in the glenoid and humeral head is closely associated with recurrence of anterior shoulder instability. The purpose of this article is to describe the open surgical techniques and introduce our experiences with anterior instability with a significant osseous defect. MATERIALS AND METHODS: We reviewed the articles that have focused on and/or mentioned the affect of osseous defects on anterior shoulder instability. The open surgical techniques and its related pearls are summarized in this review. RESULTS: Accurate evaluation for the size and location of the osseous defect is critical for preventing recurrence after restoration of the anterior capsulolabral structure. The glenoid bone restoration techniques include the coracoids transfer (the Bristow procedure and the Latarjet procedure) and a structural iliac bone graft. Rotational humeral osteotomy and an osteoarticular allograft could be used for repairing a significant posterosuperior humeral defect (Hill-Sachs lesion). Shoulder arthroplasty may be tried for treating a humeral bone defect, but more study on this is needed. CONCLUSION: Open surgical restoration decreases the risk of recurrence anterior shoulder instability that is combined with a significant osseous defect. Arthroscopic surgery currently has limitations for treating an osseous defect, but it will become useful in proportion to the development of arthroscopic instruments and techniques in the future.
Arthroplasty ; Arthroscopy ; Humeral Head ; Osteotomy ; Recurrence ; Shoulder ; Transplantation, Homologous ; Transplants

PURPOSE: Snapping triceps syndrome is dynamic condition in which medial head of triceps snaps (dislocates) over the medial epicondyle as the elbow is flexed. MATERIALS AND METHODS: The symptoms are pain or snapping at the medial aspect of the elbow and/or symptoms from coexisting ulnar nerve irritation. The diagnosis can be made by dynamic ultrasonography. RESULTS AND CONCLUSION: And successful outcome can be archived by operative treatment, which are ulnar nerve anterior transposition and tenotomy of medial head of triceps.
Dislocations ; Elbow ; Head ; Tenotomy ; Ulnar Nerve

PURPOSE: Labral lesions and its anatomic variants have been studied by several authors in the last decade. Buford complex and sublabral recess are most common variants. Their recognition is important in order to distinguish them from superior and anterior labral tear. MATERIALS AND METHODS: We report one case of a 19-year-old female who was mistaken SLAP lesion for normal variant and was treated with arthroscopic surgery. RESULTS: The arthroscopic finding shows rare normal variant of biceps anchor and superior labrum. The biceps long head tendon was inserted at superior labrum and supraspinatus tendon area. This finding was mistaken to SLAP lesion. CONCLUSION: We report rare normal variant of biceps anchor and superior labrum that was observed during arthroscopic surgery for SLAP lesion.
Arthroscopy ; Female ; Head ; Humans ; Shoulder Joint ; Tendons ; Young Adult

PURPOSE: This study examined the outcomes of closed reduction and fixation of the coracoid process fracture using a suture anchor in a patient with combined acromioclavicular dislocation for which the coraco-clavicular ligament was intact. MATERIALS AND METHODS: A 26 year-old male patient with a coracoid process fracture that was associated with a type III acromioclavicular joint dislocation was operated on with anchor suture fixation. This is the first trial of this operative procedure. RESULTS: At the postoperative follow-up at 3 months, complete union of the coracoid process fracture was seen. The shoulder had a full range of motion and the shoulder function was normal. CONCLUSION: Closed reduction and fixation using one suture anchor for treating coracoid process fracture is a safe, effective procedure.
Acromioclavicular Joint ; Dislocations ; Follow-Up Studies ; Humans ; Ligaments ; Male ; Range of Motion, Articular ; Shoulder ; Suture Anchors ; Sutures

PURPOSE: We wanted to evalulate the clinical results of pectoris major tendon transfer for a neglected winged scapula that was caused by paralysis of the serratus anterior due to injury to the long thoracic nerve. MATERIALS AND METHODS: A patient had neglected winged scapula that followed an arthroscopic operation for multi-directional instability of the shoulder joint, which was caused by traumatic dislocation. The patient was treated with pectoralis major tendon transfer using the modified Eden-Lange procedure. The range of a motion was improved from forward flexion 90degrees and external rotation 70degrees to 170degrees and 150degrees respectively. RESULTS AND CONCLUSION: There were no complications or recurrence and the patient's psychological satisfaction was also high. If the shoulder girdle muscles are intact, except for the serratus anterior, then pectoralis tendon transfer is a satisfactory method that can provide normal scapulo-thoracic motion.
Dislocations ; Humans ; Muscles ; Paralysis ; Recurrence ; Scapula ; Shoulder ; Shoulder Joint ; Tendon Transfer ; Tendons

PURPOSE: We report here on a solution for the case of a 71 year old lady with cartilage destruction in the left shoulder and the loss of the rotator cuff secondary to post-septic arthritic sequelae. MATERIALS AND METHODS: After thorough laboratory, clinical and radiological investigation of the patient to rule out any foci of active infection, we contemplated performing reverse total shoulder arthroplasty as a primary procedure. RESULTS: At 22 months follow up, the patient had an excellent result according to the UCLA and ASES scales. CONCLUSION: Reverse total shoulder arthroplasty seems to be an efficient procedure to improve pain and function in the post-septic shoulder accompanying severe rotator cuff injury.
Arthritis, Infectious ; Arthroplasty ; Cartilage ; Follow-Up Studies ; Humans ; Rotator Cuff ; Shoulder

PURPOSE: Bilateral traumatic locked posterior dislocations of the shoulder are very rare and there has been no report on the operative treatment for this injury in the Korean medical literature. MATERIALS AND METHODS: We present here a case of bilateral locked posterior dislocations of the shoulders after trauma and this was successfully treated with open reduction and lesser tuberosity transfer on the right shoulder and subscapularis tendon transfer on the left shoulder. RESULTS AND CONCLUSION: Twenty-four months later, the clinical and radiologic results were excellent.
Dislocations ; Shoulder ; Shoulder Dislocation ; Tendon Transfer

PURPOSE: For an isolated tear of the subscapularis tendon, the presented technique using a subclavian portal provides both a good angle for anchor placement and sufficient space for managing the upper portion of a subscapularis tendon tear. MATERIALS AND METHODS: The conventional method needs 2 additional portals for traction, debriding the footprint and anchor fixation for repair. The presented technique requires only an anterior portal for suture management and a subclavian portal without cannula for suture anchoring and placement of suture hooks. RESULTS: The two suture limbs of the anchor can be placed on the subscapularis tendon by the switching technique and these limbs are repaired sequentially. CONCLUSION: This technique is simple and reproducible and it can be applied to partial tears and minimally retracted subscapularis tears.
Catheters ; Extremities ; Suture Anchors ; Sutures ; Tendons ; Traction

PURPOSE: This study is to analyze the prevalence of various intra-articular lesions in patients with traumatic recurrent anterior dislocation of shoulder over 40 years and suggest clinical implications for treatment. MATERIALS AND METHODS: We retrospectively studied 16 cases that underwent surgical treatment for recurrent anterior dislocation of shoulder from January 2001 to May 2009. There were 9 males and 7 females, and the mean age was 52.7years. We carried out arthroscopic exam for all patients based on standard protocol, which included labrum, capular lesion, cuff, bony lesions. RESULTS: All 16 cases showed Hill-Sachs lesion, 3 patients (19%) had bony Bankart lesion, 6 patients (38%) had labral tear. Capsular tear were found 15 patients (94%). Twelve (75%) had ruptured supraspinatus and 5 (31%) had subscapularis tear. Only one (6%) had SLAP lesion. CONCLUSION: There was relatively higher incidence of capsular and rotator cuff tears in patients over age 40 years. Preoperative planning to address these lesions is highly recommended.
Aged ; Dislocations ; Female ; Humans ; Incidence ; Male ; Prevalence ; Retrospective Studies ; Rotator Cuff ; Shoulder ; Shoulder Dislocation

PURPOSE: In arthroscopic rotator cuff repairs there are generally weak link in tendon suture interface, arthroscopic rotator cuff repairs can have higher retear rates than open repairs. The purpose of this study was to compare the strength of UU (Ulsan University) suture than open modified MA (Mason-Allen) suture when suture anchored into bone. MATERIALS AND METHODS: The human supraspinatus tendons were harvested from the shoulder of the cadaver and split in 2 times, producing four tendons per one shoulder, for a total of 24 specimens. Two suture configurations (UU, MA) were randomized and checked on each set of tendons. Specimens were cyclically loaded under force control between 5 and 30 N at 0.25 Hz for fifty cycles. Each specimen was loaded to failure under displacement control at 1 mm/sec. Cyclic elongation, peak to peak displacement, stiffness, ultimate tensile load, mode of failure were checked. RESULTS: No significant difference was found between two suture configuration with respect to peak to peak displacement, cyclic elongation, and stiffness. With regard to ultimate failure load, there were no significant difference statistically between the UU suture and modified MA suture (109.4 N, 110.6 N). The most common mode of failure between both sutures was suture pull-out through the tendon. CONCLUSION: The UU suture and modified MA suture produced similar biomechanical properties.
Aluminum Hydroxide ; Biomechanics ; Cadaver ; Carbonates ; Displacement (Psychology) ; Humans ; Rotator Cuff ; Shoulder ; Suture Anchors ; Sutures ; Tendons