Biceps tenodesis for painful inferior subluxation of the shoulder in adult acquired hemiplegia.
Painless inferior subluxation of the shoulder is a common finding following stroke and is a manifestation of the adynamic nature of the disorder. The weight of the limb is not counterbalanced by shoulder musculature. This is a preliminary report of a simple tenodesis procedure performed in six patients with uniformly successful reduction of the subluxation. The tenodesis is performed through a short deltopectoral approach. The tendon of the long head of the biceps is looped over the coracoid process of the scapula and secured with a barbed staple, thus reducing the subluxation. The indications were painful inferior subluxation of a flail shoulder and failure of multiple orthotic attempts to relieve discomfort. Follow-up evaluation ranged from ten to 42 months with no instances of pain or recurrent subluxation in five cases. The one failure was in a patient whose pain was thought to be thalamic in origin. The subluxation was reduced, but the pain persisted.
Pinzur
M S
MS
Hopkins
G E
GE
D000328:Adult; D000368:Aged; D006429:Hemiplegia / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D012783:Shoulder Dislocation / Q000209:etiology / Q000601:surgery*; D013710:Tendons / Q000601:surgery*