Postoperative Subscapularis Muscle Insufficiency after Primary and Revision Open Shoulder Stabilization

Scheibel, Markus; Tsynman, Alexander; Magosch, Petra; Schroeder, Ralf Juergen; Habermeyer, Peter

doi:10.1177/0363546506288852

Cited by 136 publications

(113 citation statements)

References 34 publications

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“…In a high percentage of patients who have undergone open shoulder stabilization, clinical examination uncovers incompetence of the subscapularis [26,27]. The corresponding MR imaging finding is atrophy and fatty degeneration, particularly of the superior portion of the subscapularis muscle, although the tendon appears to be intact in the majority of cases.…”

Section: Anatomic Repairmentioning

confidence: 99%

Multimodality imaging of the postoperative shoulder

Woertler

2007

Eur Radiol

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Multimodality imaging of the postoperative shoulder includes radiography, magnetic resonance (MR) imaging, MR arthrography, computed tomography (CT), CT arthrography, and ultrasound. Target-oriented evaluation of the postoperative shoulder necessitates familiarity with surgical techniques, their typical complications and sources of failure, knowledge of normal and abnormal postoperative findings, awareness of the advantages and weaknesses with the different radiologic techniques, and clinical information on current symptoms and function. This article reviews the most commonly used surgical procedures for treatment of anterior glenohumeral instability, lesions of the labral-bicipital complex, subacromial impingement, and rotator cuff lesions and highlights the significance of imaging findings with a view to detection of recurrent lesions and postoperative complications in a multimodality approach.

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Section: Anatomic Repairmentioning

confidence: 99%

Multimodality imaging of the postoperative shoulder

Woertler

2007

Eur Radiol

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“…21,22 Arthroscopic repair has a lower risk of subscapularis failure and enables smaller incisions, better range of movement, and earlier return to work. Compared to the open operations, patients treated arthroscopically achieve higher functional scores postoperatively, but have a significantly increased risk of recurrent instability and dislocation (12-16%).…”

Section: Discussionmentioning

confidence: 99%

Recurrent Shoulder Dislocations Secondary to Coracoid Process Fracture: A Case Report

Lal

Bansal

Sabharwal

et al. 2012

J Orthop Surg (Hong Kong)

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Coracoid process fracture is easily missed in recurrent anterior shoulder dislocation. We report one such case in a 48-year-old man. Radiology revealed the Bankart lesion and the Hill-Sachs lesion only; the coracoid process fracture was discovered intra-operatively. The anatomy of the shoulder was restored by fixing the fragment to its scapular remnant with a 4-mm cannulated cancellous screw. The tip and the proximal fragment were reamed before inserting the screw. This fragment was routed with attached short head of biceps and coracobrachialis through the lower one third of the subscapularis, before homing it and fixing it to the proximal coracoid fragment. This extraarticular repair resulted in less stiffness than any intra-articular procedure. At the 2-year follow-up, the patient had had no further shoulder dislocation.

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“…[2][3][4][5][6][7][8][9] 또한 회전근 개의 주요 근육들 중 하나로서, 'force couple' 의 개념으로 견관절이 정상적 이며 조절된 운동을 하는데 중요한 기능을 하고 있다. 10) 그러나 견갑하근은 파열 빈도가 다른 회전근 개에 비하 여 상당히 낮은 것으로 보고되고 있으며, 9,[11][12][13] 임상적으 로도 파열을 진단하기 어려워 견관절의 기능에 미치는 중요성에 비해 간과되어진 경향이 있으며 심지어 일부 학자들 14) 은 견갑하근을"잊혀진 힘줄 (forgotten tendon)" 이라 명명하기도 하였다.…”

Section: 서 론unclassified

MR Evaluation of Tendinous Portions in the Subscapularis Muscle

Shon

Koh

Lee³

et al. 2011

The Journal of the Korean Shoulder and Elbow Society

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Purpose: The purpose of this study was to document the structural features of the tendinous portions within the non-pathologic subscapularis muscle by performing high resolution MR imaging of the shoulder. Materials and Methods: Between April 2007 and May 2010, we retrospectively obtained the MR scans of 88 consecutive young patients (88 shoulders) who were in their twenties. MRI and MR arthrography were performed using a 3.0-T system for the evaluation of glenohumeral instability and nonspecific shoulder pain. None of the patient in this study had any evidence of injury to the tendon or muscle belly of the subscapularis. On MR images, we recorded the transverse length of a stout tendinous band and the total tendinous portion of the subscapularis. In addition, we recorded the number of intramuscular tendinous slips of the susbscapularis. Results: The mean transverse length of the tendinous band was 15.0 mm (range: 8 to 20 mm). The mean transverse length of the total tendinous portion was 48.9 mm (range: 40 to 60 mm). The number of intramuscular tendinous slips on the base of the glenoid fossa was 3 in 20 (22.72%), 4 in 45 (51.14%) and 5 in 23 shoulders (26.14%). On the lateral portion, the intramuscular tendinous slips became gradually rounder and thicker and they gave converge in the superior direction. Conclusion: In this study, the structural features of the tendinous portions of the subscapularis on the MR scans were identified. This will in return give good justification for the lines to be pulled during biomechanical stimulation and also for the surgical approach to restore the biomechanical function.

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Postoperative Subscapularis Muscle Insufficiency after Primary and Revision Open Shoulder Stabilization

Cited by 136 publications

References 34 publications

Multimodality imaging of the postoperative shoulder

Multimodality imaging of the postoperative shoulder

Recurrent Shoulder Dislocations Secondary to Coracoid Process Fracture: A Case Report

MR Evaluation of Tendinous Portions in the Subscapularis Muscle

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