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.


1- Tannenbaum E, Sekiya JK. Evaluation and management of p o s t e r i o r s h o u l d e r i n s t a b i l i t y. S p o r t s He a l t h . 2011;3(3):253–263. doi:10.1177/194173811140056
2- Paul J, Buchmann S, Beitzel K, Solovyova O, Imhoff AB .Posterior Shoulder Dislocation: Systematic Review and Treatment Algorithm.The Journal of Arthroscopic and Related Surgery, Vol 27, No 11 (November), 2011: pp 1562- 1572.doi:10.1016/j.arthro.2011.06.015
3- Bäcker HC, Galle SE, Maniglio M, Rosenwasser MP. Biomechanics of posterior shoulder instability – current
knowledge and literature review. World J Orthop 2018 N o v e m b e r 1 8 ; 9 ( 1 1 ) : 2 4 5 – 2 5 4 , D O I : 10.5312/wjo.v9.i11.245
4- Moroder P, Scheibel M, ABC classification of posterior shoulder instability.Obere Extrem.2017;12(2):66- 74.doi:10.1007/s11678-017-0404-6
5- Neer CS, Foster GR (1980) inferior capsular shift in involuntary inferior and multi directional instability of the shoulder . A preliminary report. J Bone Joint Surg Am. 1980 Sep;62(6):897-908
6- Scott DJ (1967) Treatmcnt of recurrent posterior dislocations of the shoulder by glenoplasty.Report of three cases. J Bone Joint Surg Am. 1967 Apr;49(3):471-6.
7- Grammont P, Lemaire JP, Crezard L, Berard J (1983) Les luxations dites “volontaires” de l’epaule du jeune sportif. Leur traitement par tenotomie du grand rond (teres major). Acta Orthop Belg. 1983 Jan-Apr;49(1-2):257-66
8- BG Weber, LA Simpson, F Hardegger , S Gallen. Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with a large Hill-Sachs lesion. J Bone Joint Surg Am. 1984;66:1443-1450.
9- G. K. Chaudhuri, A. Sengupta & A. K. Saha (1974) Rotation Osteotomy of the Shaft of the Humerus for Recurrent
Dislocation of the Shoulder: Anterior and Posterior, Acta O r t h o p a e d i c a S c a n d i n av i c a , 4 5 : 1 – 4 , 1 9 3 – 1 9 8 , DOI:10.3109/17453677408989139
10- Surin V1, Blåder S, Markhede G, Sundholm K. Rotational osteotomy of the humerus for posterior instability of the shoulder. J Bone Joint Surg Am. 1990 Feb;72(2):181-6.
11- J.C. Meynet .Subluxation posterieure recidivante de l’epaule :que peut-on proposer ?Orthop Traumatol (1994) 4: 135.

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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