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The Deltopectoral Approach: Options for Management of the Subscapularis Tendon
A 33-year-old man presents with chronic, recurrent shoulder instability after sustaining a traumatic anterior shoulder dislocation 10 years earlier. Since that injury, the patient has experienced progressively increasing episodes of recurrent instability, resulting in an inability to perform activities of daily living without dislocating his shoulder. No substantial improvement has been achieved with physical therapy that includes strengthening of the rotator cuff and periscapular muscles. The patient has not had any previous surgical treatment. Advanced imaging shows a glenoid in the shape of an inverted pear and approximately 25% bone loss on the anterior glenoid (Figure 1). Based on the amount of glenoid bone loss, bone block transfer of the coracoid process is identified as the best treatment option.