The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J.

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Presentation transcript:

The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J Bone Joint Surg Am Volume 78(2): February 1, 1996 ©1996 by The Journal of Bone and Joint Surgery, Inc.

Figs. 1 through 9: Illustrations demonstrating the operative technique. MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Axial view, demonstrating the intended plane of dissection for reflection of the medial and lateral portions of the subscapularis tendon. MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

The inferior aspect of the capsule is exposed, and the axillary nerve is protected. MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

The anterior aspect of the glenoid is decorticated. MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Non-absorbable sutures are passed through the drill-holes for subsequent repair of the Perthes- Bankart lesion. MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

The medial aspect of the capsule is pulled taut in a lateral direction, and the suture is passed through the capsule. MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Any superior capsular defect is closed, followed by superolateral shift of the medial capsular leaflet. MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Figs. 8-A and 8-B: The lateral capsular leaflet is shifted superomedially, which double-breasts the anterior aspect of the capsule. MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

Figs. 8-A and 8-B: The lateral capsular leaflet is shifted superomedially, which double-breasts the anterior aspect of the capsule. MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.

The subscapularis tendon is reapproximated. MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78: ©1996 by The Journal of Bone and Joint Surgery, Inc.