Posterior-Inferior Capsular Shift for the Treatment of Recurrent, Voluntary Posterior Subluxation of the

Shoulder*

by BRUNO FUCHS, BERNHARD JOST, and CHRISTIAN GERBER

J Bone Joint Surg AmVolume 82(1):16-25

January 1, 2000

©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-A: Photographs showing a patient who was able to voluntarily subluxate the shoulder posteriorly by internal rotation and flexion (Fig. 1-A) and to relocate it by external rotation,

adduction, and flexion (Fig. 1-B).

BRUNO FUCHS et al. J Bone Joint Surg Am 2000;82:16-25

©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-B: Photographs showing a patient who was able to voluntarily subluxate the shoulder posteriorly by internal rotation and flexion (Fig. 1-A) and to relocate it by external rotation,

adduction, and flexion (Fig. 1-B).

BRUNO FUCHS et al. J Bone Joint Surg Am 2000;82:16-25

©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-A: Illustrations showing the posterior-inferior capsular shift procedure as performed in the present study.

BRUNO FUCHS et al. J Bone Joint Surg Am 2000;82:16-25

©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-B: Illustrations showing the posterior-inferior capsular shift procedure as performed in the present study.

BRUNO FUCHS et al. J Bone Joint Surg Am 2000;82:16-25

©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3 Intraoperative photograph of the glenohumeral joint after the T-shaped incision was created in the posterior aspect of the capsule.

BRUNO FUCHS et al. J Bone Joint Surg Am 2000;82:16-25

©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 4 Photograph made after the operation, showing a patient wearing a splint that prevented inferior traction and internal rotation of the arm for six weeks.

BRUNO FUCHS et al. J Bone Joint Surg Am 2000;82:16-25

©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 5-A A preoperative arthro-computerized tomography scan showing a very wide capsule and a rounded but otherwise normal posterior aspect of the labrum (arrowhead).

BRUNO FUCHS et al. J Bone Joint Surg Am 2000;82:16-25

©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 5-B Intraoperative photograph showing the very large inferior flap (arrowhead) of the posterior aspect of the capsule and an intact posterior portion of the labrum.

BRUNO FUCHS et al. J Bone Joint Surg Am 2000;82:16-25

©2000 by The Journal of Bone and Joint Surgery, Inc.