Results of Derotational Humeral Osteotomy in Posterosuperior Glenoid Impingement

We identified 20 throwing athletes who continued to have pain after articular debridement for posterosuperior impingement syndrome. These patients were unable to resume sports, and we subsequently performed a derotational humeral osteotomy with a myorraphy of the subscapularis muscle. Patients were...

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Bibliographic Details
Published in:The American journal of sports medicine 1998-05, Vol.26 (3), p.453-459
Main Authors: Riand, Nicolas, Levigne, Christophe, Renaud, Eric, Walch, Gilles
Format: Article
Language:English
Subjects:
Adult
Athletes
Athletic Injuries - surgery
Biological and medical sciences
Bone Screws
Diseases of the osteoarticular system
Female
Humans
Humerus - surgery
Joint diseases
Juxtaarticular diseases. Extraarticular rhumatism
Male
Medical sciences
Osteotomy - methods
Pain - etiology
Pain - surgery
Rotator Cuff - surgery
Rotator Cuff Injuries
Shoulder
Shoulder Impingement Syndrome - surgery
Shoulder joint
Shoulder Joint - injuries
Shoulder Joint - surgery
Sports injuries
Sports medicine
Surgery
Treatment Outcome
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Summary:We identified 20 throwing athletes who continued to have pain after articular debridement for posterosuperior impingement syndrome. These patients were unable to resume sports, and we subsequently performed a derotational humeral osteotomy with a myorraphy of the subscapularis muscle. Patients were observed for an average of 46 months (range, 12 to 69). Eleven patients were able to resume the same sport at the same level, five resumed the same sport at a lower level, three changed sport secondary to persistent pain, and the last patient did not resume any sport and was worse after surgery. Patients returned to sports at an average of 6 months postoperatively (range, 4 to 44) and to their previous level of sports at an average of 12 months (range, 8 to 18). The mean increase in humeral retroversion was 29° (range, 18° to 44°). Three women with preoperative multidirectional hyperlaxity were considered to have failed results. Derotational humeral osteotomy can be considered in the throwing athlete with posterosuperior impingement after failure of all other means of treatment. Careful patient selection and preoperative evaluation of humeral retroversion is important. Best results can be achieved in a motivated patient with low retroversion (
ISSN:0363-5465
1552-3365
DOI:10.1177/03635465980260032001