the capsular imbrication procedure for recurrent anterior instability of the shoulder*† by michael...
TRANSCRIPT
![Page 1: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/1.jpg)
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 AmVolume 78(2):246-60
February 1, 1996
©1996 by The Journal of Bone and Joint Surgery, Inc.
![Page 2: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/2.jpg)
Figs. 1 through 9: Illustrations demonstrating the operative technique.
MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78:246-60
©1996 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/3.jpg)
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;78:246-60
©1996 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/4.jpg)
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;78:246-60
©1996 by The Journal of Bone and Joint Surgery, Inc.
![Page 5: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/5.jpg)
The anterior aspect of the glenoid is decorticated.
MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78:246-60
©1996 by The Journal of Bone and Joint Surgery, Inc.
![Page 6: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/6.jpg)
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;78:246-60
©1996 by The Journal of Bone and Joint Surgery, Inc.
![Page 7: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/7.jpg)
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;78:246-60
©1996 by The Journal of Bone and Joint Surgery, Inc.
![Page 8: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/8.jpg)
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;78:246-60
©1996 by The Journal of Bone and Joint Surgery, Inc.
![Page 9: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/9.jpg)
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;78:246-60
©1996 by The Journal of Bone and Joint Surgery, Inc.
![Page 10: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/10.jpg)
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;78:246-60
©1996 by The Journal of Bone and Joint Surgery, Inc.
![Page 11: The Capsular Imbrication Procedure for Recurrent Anterior Instability of the Shoulder*† by MICHAEL A. WIRTH, GEORGE BLATTER, and CHARLES A. ROCKWOOD J](https://reader036.vdocuments.site/reader036/viewer/2022062320/56649d145503460f949e921c/html5/thumbnails/11.jpg)
The subscapularis tendon is reapproximated.
MICHAEL A. WIRTH et al. J Bone Joint Surg Am 1996;78:246-60
©1996 by The Journal of Bone and Joint Surgery, Inc.