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Purpose: The aim of the present study was to describe our experience with French Elbow Connection (FEC) (i.e. elbow reduction and triple ligamentoplasty) for patients with chronic elbow dislocation (CED)., Materials and Methods: We performed a retrospective review of 12 patients in two departments of orthopaedic surgery undergoing the FEC procedure for CED between 2019 and 2024. The median follow-up was 1.80 years (IQR 1.00; 1.97). Range of motion, mean Mayo Elbow Performance score (MEPS), visual analog scale (VAS), elbow stability, and radiographic outcome were recorded., Results: Median MEPS and VAS were 90.00 points (IQR 75.60; 100.00) and 0 (IQR 0; 1.50), respectively. Eight (66%) patients reported no pain. The median active flexion-extension and prono-supination arcs were 145°(IQR 102.60; 150.00), and 170°(IQR 155.03; 170.00) respectively. Persistent valgus or varus instability was identified in 2 (17%), and 1 (8%) patient respectively. Size patients (50%) were diagnosed with osteoarthritis (OA) and 1 patient experienced worsening postop OA (from grade 1(preop) to 3(postop))., Conclusion: CED is a complex condition that presents elbow surgeons with unique challenges. The FEC procedure allows for immediate active ROM and yielded satisfactory short-term outcomes in our hands. Larger, longer-term studies will be necessary to assess reproducibility and confirm results can be maintained over time., Level of Evidence: level IV; therapeutic study (case series [no, or historical, control group])., Competing Interests: Declarations. Ethics approval and consent to participate: Regarding the french law (Jardé, 18Nov2016, https://sante.gouv.fr/systeme-de-sante/innovation-et-recherche/recherche-impliquant-la-personne-humaine/foire-aux-questions/article/les-categories-de-recherches ), retrospective data collection do not required the approval of an IRB. Data protection was maintained as all the data have been collected in agree with an appropriate procedure in the University hospital of Toulouse and Bordeaux. Competing interests: The authors declare no competing interests., (© 2025. The Author(s) under exclusive licence to SICOT aisbl.)

Purpose: The purpose of the study is to report the results of reverse shoulder arthroplasty (RSA) after three types of initial treatment performed for complex proximal humeral fracture (PHF): conservative, reduction and internal fixation (RIF), or hemiarthroplasty., Methods: This is a retrospective study of 63 patients separated into three groups with a minimum follow-up of two years. Group I included 25 patients with an initial conservative fracture treatment, group II included 25 patients treated by RIF, and group III included 13 patients initially treated by hemiarthroplasty. Patients were assessed using the absolute Constant-Murley score, functional parameters, complications rate, and radiological follow-up., Results: One patient died and five were lost to follow-up. All functional outcomes improved significantly post-operatively for the three groups (p < 0.005). The mean Constant-Murley score increased from 13.7 to 54.1 (group I); 16.6 to 48.5 (group II); and 22.6 to 48.2 (group III) (p < 0.001). The gain of Constant-Murley and SST scores was better for group I (p = 0.049 and 0.028, respectively), while post-operative pain was better in group III (p = 0.033). The complication rate was 38% in group III, 30% in group II, and 14.3% in group I., Conclusions: Reverse shoulder arthroplasty represents a good surgical option in complex proximal humeral fracture sequelae. Whatever the initial treatment, function and motion of the shoulder are improved. The final result is better if the initial treatment was conservative. The group initially treated with hemiarthroplasty had the most complications.

Purpose: The transfer of the pectoralis major in cases of irreparable rupture of the subscapularis has been described through different techniques. The aim of this prospective study was to compare the clinical results of transferring the clavicular or the sternal head of the pectoralis major tendon underneath the conjoint tendon., Methods: Fifteen patients underwent the procedure, including eight clavicular head of the pectoralis major tendon transfers and seven sternal head transfers. The mean age at the time of surgery was 57 years (range, 37-66). Each patient had pre-operative MRI and CT scan. The criteria for an irreparable subscapularis tear were retraction at the level of the glenoid and fatty infiltration of the muscle graded III or IV. Pre-operative and postoperative functions were assessed by the Constant score. Patients were finally asked if they were very satisfied, satisfied or unhappy with the functional outcome., Results: The average follow-up was 24 months (range, 12-50). The mean absolute Constant score of the entire series increased significantly from 36 preoperatively to 69 at the latest follow up (p < 0.01); it improved significantly and similarly in both types of tendon harvested. Nine patients were very satisfied, three were satisfied and three were dissatisfied with the clinical outcome., Conclusion: A clavicular or a sternocostal head transfer of the pectoralis major under the coracoid process reduced pain, and improved the strength and function of the shoulder.