Filling a humeral head defect with a chondrocostal autograft combined with subscapularis transfer for chronic posterior glenohumeral dislocations

• Published in: Revue de chirurgie orthopédique et réparatrice de l'apparell moteur Vol. 94; no. 5; p. 503
• Main Authors: Lepage, D, Obert, L, Rochet, S, Gallinet, D, Garbuio, P, Tropet, Y
• Format: Journal Article
• Language: French
• Published: France 01-09-2008
• Subjects: Adult; Bone Transplantation; Cartilage, Articular - transplantation; Chronic Disease; Female; Follow-Up Studies; Humans; Humerus - surgery; Range of Motion, Articular; Ribs; Shoulder Dislocation - classification; Shoulder Dislocation - diagnostic imaging; Shoulder Dislocation - surgery; Shoulder Joint - physiology; Tendon Transfer; Time Factors; Tomography, X-Ray Computed; Transplantation, Autologous; Treatment Outcome
• ISSN: 0035-1040
• DOI: 10.1016/j.rco.2008.02.010

Mac Lauglhin defects of the right humeral head developed in a 44-year-old woman with drug-resistant epileptic seizures, subsequent to recurrent posterior dislocations. The preoperative work-up demonstrated a large anterior defect corresponding to more than 50% loss of the osterochondral tissue. The humeral head lodged on the posterior rim of the scapular glenoid, like an inveterate posterior dislocation, causing major pain and joint dysfunction. After adjustment of the antiepilepsy treatment, the patient underwent joint reconstruction with a chondrocostal autograft harvested from the ninth homolateral rib combined with transfer of the lesser tubercle. At three years follow-up, the patient has a stable pain-free shoulder with a satisfactory range of motion. The graft was integrated.