- Putti Platt:
- tightening, & realigning of subscapularis which partially limits external rotation;
- anterior capsule is also realinged and reenforced;
- subscapularis is divided 2.5 cm from its insertion;
- anterior shoulder capsule is opened in same plane as tendon is divided allowing joint to be inspected;
- some advocate separation of capsule from overlying subscapularis tendon;
- lateral stump of the tendon is secured to most convenient soft tissue structure along the anterior rim of the glenoid cavity;
- opposition of lateral stump into anterior soft tissues of medial stump into greater tuberosity is determined so that arm externally rotates to neutral position;
- DuToit Staple Capsulorrhaphy;
- detached capsule is secured back to the glenoid using staples;
- use of staples for surgical repairs may be assoc w/ complications;
- Bristow:
- transfers the tip of the coracoid process with its muscle attachments & creates a musculotendinous sling across the anteroinferior tendon at the front of the glenohumeral joint
The modified Bristow procedure for recurrent dislocation of the shoulder.