Rockwood Adults CH34

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CHAPTER 34 • Glenohumeral Instability

A

B

C

D

Figure 34-42.  A: Posterior “T” capsulotomy is performed with Fakuda inserted into the glenohumeral joint to allow exposure. Alternatively, a Bankart retractor can be inserted over the glenoid neck to expose the posterior labral tear for repair. B: Posterior capsulotomy is tagged with no. 2 braided sutures. C: Posterior capsular shift is performed and the capsule is sutured together in a pants-over-vest fashion. D: Final posterior capsular shift is seen here after suture repair.

on the glenoid rim through the capsulolabral tissue starting at the most inferior portion of the tear and continuing superiorly until the labral lesion is repaired. Following the labral repair, a repair of the capsular split is performed. A capsular shift can be performed as well by completing a “pants over vest” repair if capsular laxity or redundancy is part of the pathologic problem

(Fig. 34-42C). A single 4.5- or 5.5-mm anchor is placed at the footprint of the infraspinatus/teres minor and is used to repair these tendons back to their anatomic insertions (Fig. 34-42D). The deltoid split is closed with running no. 2 sutures and skin is closed with 3-0 Monocryl and Dermabond. The patient is placed in an external rotation sling.