Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint
The surgical repair of an extensive anterior glenohumeral soft tissue defect is complicated by glenohumeral instability and subsequent significant functional deficit. This surgical note offers a relatively simple reconstruction of the anterior capsule and subscapularis muscle using a pectoralis mino...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2014/937342 |
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| author | Michiel A. J. van de Sande Tom Cosker Stephen M. McDonnell C. L. M. H. Gibbons Henk Giele |
| author_facet | Michiel A. J. van de Sande Tom Cosker Stephen M. McDonnell C. L. M. H. Gibbons Henk Giele |
| author_sort | Michiel A. J. van de Sande |
| collection | DOAJ |
| description | The surgical repair of an extensive anterior glenohumeral soft tissue defect is complicated by glenohumeral instability and subsequent significant functional deficit. This surgical note offers a relatively simple reconstruction of the anterior capsule and subscapularis muscle using a pectoralis minor pedicle flap. This reconstruction is supplemented with functional reconstruction of the anterior glenohumeral joint. A conventional deltopectoral approach is utilized and pectoralis minor is freed from its coracoid insertion, released, and mobilized without compromising the pedicle entering from the dorsum and inferior one-third of the muscle. The mobilized pectoralis minor vascular pedicle has sufficient length for the pectoralis minor to be transferred to provide coverage of the anterior shoulder joint even in full external rotation, providing anterior stability. To further improve glenohumeral stability and shoulder function, the pectoralis major muscle can be split with the clavicular part reinserted lateral to the bicipital groove onto the lesser tuberosity replacing subscapularis function while stabilising the glenohumeral joint. |
| format | Article |
| id | doaj-art-00db27be8c9b4e19acd7f2a849f05968 |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-00db27be8c9b4e19acd7f2a849f059682025-02-03T06:08:10ZengWileyCase Reports in Orthopedics2090-67492090-67572014-01-01201410.1155/2014/937342937342Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral JointMichiel A. J. van de Sande0Tom Cosker1Stephen M. McDonnell2C. L. M. H. Gibbons3Henk Giele4Department of Orthopaedics, LUMC, Albinusdreef 2, 2300 RC Leiden, NetherlandsThe Oxford Bone and Soft Tissue Tumour Service, Nuffield Orthopaedic Centre, Oxford, UKThe Oxford Bone and Soft Tissue Tumour Service, Nuffield Orthopaedic Centre, Oxford, UKThe Oxford Bone and Soft Tissue Tumour Service, Nuffield Orthopaedic Centre, Oxford, UKThe Oxford Bone and Soft Tissue Tumour Service, Nuffield Orthopaedic Centre, Oxford, UKThe surgical repair of an extensive anterior glenohumeral soft tissue defect is complicated by glenohumeral instability and subsequent significant functional deficit. This surgical note offers a relatively simple reconstruction of the anterior capsule and subscapularis muscle using a pectoralis minor pedicle flap. This reconstruction is supplemented with functional reconstruction of the anterior glenohumeral joint. A conventional deltopectoral approach is utilized and pectoralis minor is freed from its coracoid insertion, released, and mobilized without compromising the pedicle entering from the dorsum and inferior one-third of the muscle. The mobilized pectoralis minor vascular pedicle has sufficient length for the pectoralis minor to be transferred to provide coverage of the anterior shoulder joint even in full external rotation, providing anterior stability. To further improve glenohumeral stability and shoulder function, the pectoralis major muscle can be split with the clavicular part reinserted lateral to the bicipital groove onto the lesser tuberosity replacing subscapularis function while stabilising the glenohumeral joint.http://dx.doi.org/10.1155/2014/937342 |
| spellingShingle | Michiel A. J. van de Sande Tom Cosker Stephen M. McDonnell C. L. M. H. Gibbons Henk Giele Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint Case Reports in Orthopedics |
| title | Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint |
| title_full | Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint |
| title_fullStr | Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint |
| title_full_unstemmed | Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint |
| title_short | Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint |
| title_sort | use of the composite pedicled pectoralis minor flap after resection of soft tissue sarcoma in reconstruction of the glenohumeral joint |
| url | http://dx.doi.org/10.1155/2014/937342 |
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