Dataset Information

Arthroscopic-Assisted Pectoralis Minor Transfer for Irreparable Tears of the Upper Two-thirds of the Subscapularis Tendon: Surgical Technique.

ABSTRACT: Open transfer of the pectoralis minor through a deltopectoral approach has been described to treat irreparable tears of the upper two-thirds of the subscapularis. We present a less invasive arthroscopic-assisted technique for this transfer. Atraumatic dissection of the pectoralis minor and harvesting of the tendon with a bone chip from the coracoid process allow strong fixation with a double-button device on the lesser tuberosity. This arthroscopic technique allows assessment and treatment of associated intra- or extra-articular lesions and represents a promising option for the management of irreparable tears of the subscapularis.

SUBMITTER: Cartaya M

PROVIDER: S-EPMC5709706 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Publications

Arthroscopic-Assisted Pectoralis Minor Transfer for Irreparable Tears of the Upper Two-thirds of the Subscapularis Tendon: Surgical Technique.

Cartaya Marco M Werthel Jean-David JD Valenti Philippe P

Arthroscopy techniques 20170904 5

Open transfer of the pectoralis minor through a deltopectoral approach has been described to treat irreparable tears of the upper two-thirds of the subscapularis. We present a less invasive arthroscopic-assisted technique for this transfer. Atraumatic dissection of the pectoralis minor and harvesting of the tendon with a bone chip from the coracoid process allow strong fixation with a double-button device on the lesser tuberosity. This arthroscopic technique allows assessment and treatment of as ...[more]

PMID: 29354465

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Project description:PurposeThe term "pectoralis minor syndrome" refers to this constellation of symptoms that can occur when the pectoralis minor (Pm) is shortened and contracted. Release of the tendon of the Pm from the coracoid has been reported to provide substantial clinical improvement to patients presenting with pectoralis minor syndrome. The purpose of this study was (1) to describe the technique for endoscopic release of pectoralis minor tendon at the subdeltoid space, (2) to classify the pectoralis minor syndrome according to its severity and (3) and to report the short-term outcomes of this procedure in a consecutive series of patients diagnosed with pectoralis minor syndrome.MethodsEndoscopic release of the pectoralis minor tendon was performed in a series of 10 patients presenting with pectoralis minor syndrome. There were six females and four males with a median age at the time of surgery of 42 (range from 20 to 58) years. Four shoulders were categorized as grade I (scapular dyskinesis), and six as grade II (intermittent brachial plexopathy). Shoulders were evaluated for pain, motion, satisfaction, subjective shoulder value (SSV), quick-DASH, ASES score, and complications. The mean follow-up time was 19 (range, 6 to 49) months.ResultsArthroscopic release of the tendon of the Pm led to substantial resolution of pectoralis minor syndrome symptoms in all but one shoulder, which was considered a failure. Preoperatively, the median VAS for pain was 8.5 (range, 7-10) and the mean SSV was 20% (range, 10% - 50%). At most recent follow-up the mean VAS for pain was 1 (range, 0-6) and the mean SSV 80% (range, 50% - 90%). Before surgery, mean ASES and quick-DASH scores were 19.1 (range, 10-41.6) and 83.1 (range, 71 and 95.5) points respectively. At most recent follow-up, mean ASES and quick-DASH scores were 80.1 (range, 40-100) and 19.3 (range, 2.3-68) points respectively. No surgical complications occurred in any of the shoulder included in this study.ConclusionsEndoscopic release of the tendon of the pectoralis minor from the coracoid improves pain, function and patient reported outcomes in the majority of patients presenting with the diagnosis of isolated pectoralis minor syndrome.

Dataset Information

Arthroscopic-Assisted Pectoralis Minor Transfer for Irreparable Tears of the Upper Two-thirds of the Subscapularis Tendon: Surgical Technique.

Publications

Arthroscopic-Assisted Pectoralis Minor Transfer for Irreparable Tears of the Upper Two-thirds of the Subscapularis Tendon: Surgical Technique.

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