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Reconstruction of the coracoacromial ligament during a modified Latarjet procedure: a case series.

Aurich M, Hofmann GO, Gras F - BMC Musculoskelet Disord (2015)

Bottom Line: The coracoacromial ligament (CAL) is an important restraint to superior shoulder translation.The PMFF is a safe technique for reconstruction of the CAL during a modLAT procedure.Patients had improved shoulder function and no re-dislocations after the surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Trauma Surgery, Sana Kliniken Leipziger Land, Sana Klinikum Borna, Rudolf-Virchow-Str. 2, 04552, Borna, Germany. kontakt@matthias-aurich.de.

ABSTRACT

Background: The coracoacromial ligament (CAL) is an important restraint to superior shoulder translation. CAL release with the Latarjet procedure leads to increased superior humeral translation. Therefore, a surgical technique was developed to reconstruct the CAL during a modified Latarjet procedure.

Methods: Between May 2010 and July 2011, six patients (five were male, one was female; age 23-41 years) with chronic post-traumatic anterior shoulder instability were treated surgically with a modified congruent-arc Latarjet procedure (modLAT) with additional reconstruction of the CAL using a newly developed procedure, the pectoralis minor fascia flap (PMFF). Clinical follow-up was performed for up to 36 months, and patients were evaluated using a Rowe score.

Results: All six patients experienced chronic, post-traumatic anterior shoulder instability and had experienced multiple re-dislocations after initial treatment. The preoperative assessment showed a defect of the anterior glenoid in three cases, and the mean Rowe score was 16.67 (5-25). Open modLAT with PMFF resulted in a stable shoulder function with no re-dislocations. The Rowe score increased from 77.5 (65-90) at 12 weeks to 95 (90-100) at 12 months and plateaued thereafter. Operative duration was 95 min (78-112 min), and there were no intra- or postoperative complications. All patients returned to their preoperative sports activity, three at the same level.

Conclusion: The PMFF is a safe technique for reconstruction of the CAL during a modLAT procedure. Patients had improved shoulder function and no re-dislocations after the surgery.

No MeSH data available.


Related in: MedlinePlus

The Semi-Beach-chair Position Used for the Operation. The position must allow true anteroposterior- and axial-view x-rays. The image intensifier is seen in the back. The coracoid process is marked with an X. The skin incision is just lateral to it (insert)
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Fig2: The Semi-Beach-chair Position Used for the Operation. The position must allow true anteroposterior- and axial-view x-rays. The image intensifier is seen in the back. The coracoid process is marked with an X. The skin incision is just lateral to it (insert)

Mentions: Surgery was performed under general anesthesia. In addition, a scalene block was administered. The patient was placed in a semi-beach chair position. The landmarks were identified and the skin incision was marked (Fig. 2). The operative technique is as follows:Fig. 2


Reconstruction of the coracoacromial ligament during a modified Latarjet procedure: a case series.

Aurich M, Hofmann GO, Gras F - BMC Musculoskelet Disord (2015)

The Semi-Beach-chair Position Used for the Operation. The position must allow true anteroposterior- and axial-view x-rays. The image intensifier is seen in the back. The coracoid process is marked with an X. The skin incision is just lateral to it (insert)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4559879&req=5

Fig2: The Semi-Beach-chair Position Used for the Operation. The position must allow true anteroposterior- and axial-view x-rays. The image intensifier is seen in the back. The coracoid process is marked with an X. The skin incision is just lateral to it (insert)
Mentions: Surgery was performed under general anesthesia. In addition, a scalene block was administered. The patient was placed in a semi-beach chair position. The landmarks were identified and the skin incision was marked (Fig. 2). The operative technique is as follows:Fig. 2

Bottom Line: The coracoacromial ligament (CAL) is an important restraint to superior shoulder translation.The PMFF is a safe technique for reconstruction of the CAL during a modLAT procedure.Patients had improved shoulder function and no re-dislocations after the surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Trauma Surgery, Sana Kliniken Leipziger Land, Sana Klinikum Borna, Rudolf-Virchow-Str. 2, 04552, Borna, Germany. kontakt@matthias-aurich.de.

ABSTRACT

Background: The coracoacromial ligament (CAL) is an important restraint to superior shoulder translation. CAL release with the Latarjet procedure leads to increased superior humeral translation. Therefore, a surgical technique was developed to reconstruct the CAL during a modified Latarjet procedure.

Methods: Between May 2010 and July 2011, six patients (five were male, one was female; age 23-41 years) with chronic post-traumatic anterior shoulder instability were treated surgically with a modified congruent-arc Latarjet procedure (modLAT) with additional reconstruction of the CAL using a newly developed procedure, the pectoralis minor fascia flap (PMFF). Clinical follow-up was performed for up to 36 months, and patients were evaluated using a Rowe score.

Results: All six patients experienced chronic, post-traumatic anterior shoulder instability and had experienced multiple re-dislocations after initial treatment. The preoperative assessment showed a defect of the anterior glenoid in three cases, and the mean Rowe score was 16.67 (5-25). Open modLAT with PMFF resulted in a stable shoulder function with no re-dislocations. The Rowe score increased from 77.5 (65-90) at 12 weeks to 95 (90-100) at 12 months and plateaued thereafter. Operative duration was 95 min (78-112 min), and there were no intra- or postoperative complications. All patients returned to their preoperative sports activity, three at the same level.

Conclusion: The PMFF is a safe technique for reconstruction of the CAL during a modLAT procedure. Patients had improved shoulder function and no re-dislocations after the surgery.

No MeSH data available.


Related in: MedlinePlus