Open Modified Gallie Procedure for Chronic Anterior Shoulder Instability

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Reconstruction

Background:

• Recurrent shoulder dislocations can stem from capsular insufficiency, often linked to humeral avulsion of the glenohumeral ligaments (HAGL).
• Adhesive capsulitis can precede or coexist with instability, complicating diagnosis and treatment.

Purpose of the Study:

• To describe the surgical technique and outcomes of open modified Gallie anatomic reconstruction for capsular insufficiency with HAGL lesions.
• To evaluate the efficacy of tibialis anterior allograft and inferior capsular shift in treating recurrent anterior shoulder instability.

Main Methods:

• A 65-year-old female with a history of adhesive capsulitis and recurrent dislocations underwent open anterior capsular reconstruction.
• The procedure involved a tibialis anterior allograft for glenoid-humeral fixation and an inferior capsular shift for the torn inferior glenohumeral ligament.

Main Results:

• The patient experienced immediate resolution of shoulder instability and pain post-surgery.
• Satisfactory functional outcomes were noted at 12 months, with only minor limitations in overhead and internal rotation activities.

Conclusions:

• Open anterior capsular reconstruction combined with inferior capsular shift is a viable and effective treatment for recurrent anterior shoulder dislocations due to capsular insufficiency and HAGL lesions.
• This surgical approach offers significant pain relief and restoration of shoulder stability.