Fully Arthroscopic Pectoralis Minor Tendon Transfer with Bone Fragment for Irreparable Subscapularis Tears

Several techniques to treat irreparable subscapularis (SSC) tendon tear have been described. We introduce a fully arthroscopic technique for pectoralis minor tendon with bone fragment transfer. This procedure starts with glenohumeral exploration and evaluation of the remaining SSC mobility. Then we detach and release the pectoralis minor (PMi) tendon with bone fragment from the coracoid, protecting the plexus structures. Next, the PMi tendon with bone fragment is fixed on the lesser tuberosity passing under the coracoid. This procedure is technically demanding and could be performed safely with low invasiveness and high reproducibility by understanding the regional anatomy and the well-described technique.