Posterolateral approach of the shoulder: assessment of 50 cases.

A new posterior approach of the shoulder for hemiarthroplasty or total arthroplasty has been used 53 times over a 6-year period. The posterior part of the deltoid is detached subperiosteally from the spine and the posterior aspect of the acromion. Distally, the incision is made between the posterior and middle parts of the muscle. The subacromial bursa is opened to reveal the plane of the external rotator muscles. The articular approach is performed by means of an osteotomy of the external rotator muscles' insertion. This approach provides a wide exposure of the joint. The socket can be seen almost head-on, which eases glenoid preparation during arthroplasty. Transosseous reinsertion of the osteotomy fragments seems stronger that tendinous suture. One early case of failure of external rotator muscle repair was recorded. Atrophy of the posterior deltoid was found in 2 cases.