SHOULDER

Pectoralis major transfer to restore internal rotation of the shoulder

Pectoralis major tendon transfer is a procedure recommended when the tendon of the subscapularis muscle (the main muscle responsible for internal rotation of the shoulder) is irreparably torn.

 

The procedure involves detaching part of the pectoralis major tendon from its insertion on the humerus, then transferring and securing it in place of the deficient subscapularis. The pectoralis major muscle then partially takes over to restore internal rotation and improve the anterior stability of the shoulder.

Before surgery:

 

  • Irreparable tear of the subscapularis.
  • Loss of internal rotation and anterior instability.

After surgery:

 

  • Pectoralis major tendon transferred and fixed to the trochlea.
  • New internal rotation strength.
  • Improved centration of the humeral head.

What are the objectives?

 

  • To reduce pain.
  • To restore some of the internal rotation strength (reaching behind your back, fastening a bra, tucking in a shirt, etc.).
  • To improve shoulder stability.
  • To limit the progression to secondary osteoarthritis.

Post-operative care

 

  • Immobilisation with a splint for approximately 4 to 6 weeks.
  • Gradual rehabilitation under the supervision of a physiotherapist.
  • Return to normal activities after around 2 to 3 months.
  • Functional recovery continues for 6 to 12 months.

Expected outcomes

 

This procedure does not restore the shoulder to normal, but it often leads to a significant improvement in pain, stability and function in patients with an irreparable subscapularis tear.