Derotational humerus osteotomy and teres major tenotomy for recurrent posterior shoulder instability: A case report

Acta of Shoulder and Elbow Surgery | Volume 3 | Issue 2 | July-December 2019 | Page 6-10 |  Jad Chbib Abi Raad, Denis Bouttens, Simon Lebbos, Christophe Obry

Authors:  Jad Chbib Abi Raad [1], Denis Bouttens [1], Simon Lebbos [1], Christophe Obry [1].

[1] Department of Orthopaedics, Fondation Hopale – Institut Calot (France)

Address of Correspondence
Dr. Jad Chbib Abi Raad ,
Fondation Hopale – Institut Calot (France)


Posterior instability represents about 10 percent of shoulder instabilities. It enclose dislocation or more frequently posterior sub luxation. Posterior instability can be also associated with constitutional laxity and multidirectional instability. The factors related to this instability depends of the etiology (traumatic, atraumatic), bony factors (glenoid and humeral head, defects, ante and retroversions) and the soft tissues. We describe a case of 28 year old lady, with recurrent posterior shoulder instability despite 3 previous interventions (2 posterior bone blocks and a glenoid osteotomy). For the treatment we combined two techniques: Derotational humerus osteotomy and Teres major tenotomy. We found that Derotational humerus osteotomy can be used as an alternative for glenoid osteotomy, or after failed glenoid osteotomy, to treat the instability. It can be associated with teres major tenotomy which was previously described mainly for voluntary posterior dislocation.
Keywords: Posterior instability, Posterior subluxation , Laxity, Derotational osteotomy, Teres major tenotomy, voluntary, involuntary.


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How to Cite this article: Jad Chbib Abi Raad J, Bouttens D, Lebbos S, Obry C. Derotational humerus
osteotomy and teres major tenotomy for recurrent posterior shoulder instability: A Case report. Acta of Shoulder and Elbow Surgery July – Dec 2019; 3(2): 6-10.

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Randomized controlled trial comparing local autologous bloodinjection and polidocanol injection for treatment of lateral epicondylosis of elbow

Acta of Shoulder and Elbow Surgery | Volume 3 | Issue 2 | July – Dec 2019 | Page 2-5 |  Rajendra Didel, Saurabh Kumar

Authors:  Rajendra Didel [1], Saurabh Kumar [2].

[1] Department of Orthopaedics, Govt Medical College, Pali, Rajasthan, India.
[2] Department of Orthopaedics, U.C.M.S & G.T.B Hospital, Delhi, India.

Address of Correspondence
Dr. Saurabh Kumar,
U.C.M.S & G.T.B Hospital, Delhi, India.


Background: Lateral epicondylosis has been found to occur in approximately 2% of general population. It’s etiology and management still remains controversial. Various studies have shown benefits with local injection of autologous blood and polidocanol individually. However, there is paucity of studies comparing the results between these both, hence we envisage to compare the clinical and functional outcomes of local autologous blood versus polidocanol injection for the treatment of lateral epicondylosis of elbow.
Materials and methods: 60 patients (age group- 18 to 60 years)with clinically diagnosed lateral epicondylosis of elbow were enrolled for the study. They were randomized into 2 groups. Group I (n = 30) was treated with autologous blood injection and Group II (n = 30) with polidocanol injection after Nirschl staging. Patients were evaluated clinically at 6& 12 weeks after the injection and were again staged by Nirschl staging on both the visits.
Results: 34 patients successfully completed 12 weeks follow-up and were included in the analysis. It was observed that clinical outcomes in terms of Nirschl score at 6 and 12 weeks was better in Group I as compared to Group II. Statistical comparison between the two groups revealed that mean values of Nirschl score were lower in group I (4.41+1.004 and 3.71+1.532 at 6 weeks and 12 weeks of follow-up respectively) as compared to group II (4.76+1.300 and 4.47+1.281at 6 weeks and 12 weeks follow-up respectively). Down staging of disease symptom was clinically better in group I (16/17) as compared to group II (11/17). However the difference in the mean values of Nirschl score between the groups was not statistically significant (p=0.342).
Conclusion: Although autologous blood injection showed a better clinical improvement as compared to polidocanol injection, the difference was not statistically significant between these both.
Keywords: Lateral epicondylosis, Autologous blood injection, Polidocanol injection


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How to Cite this article: Didel R, Kumar S. Randomized controlled trial comparing local autologous
blood injection and polidocanol injection for treatment of lateral epicondylosis
of elbow. Acta of Shoulder and Elbow Surgery July – Dec 2019; 3(2): 2-5.

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