From 1979 until 1987, the Boytchev procedure was performed on twenty-four shoulders of twenty-four patients. They were followed up after a mean observation time of 51.3 months. There were no recurrences except for in one patient, who experienced redislocation due to an unacceptable shoulder position just after surgery. Moreorer, two experienced a feeling of subluxation, but not a complete dislocation, and one had a recurrent subluxation.
Nine of the patients had limitation of external rotation. Three o f them were patients who had been treated for rotator cuff rupture with the McLaughlin method combined with the Boytchev procedure and had had significant preoperative limitation of external rotation. In another six patients, the amount of limitation was less than ten degrees, so they felt no inconvenience in their daily activities or sports. Nine of the patients had nerve complica- 'tions; total musculocutaneous nerve palsy was diagnosed in two patients; numbness in the radial side of the forearm in five patients, in the area of the median nerve in one patient, and in both areas in the other. These symptoms almost disappeared in a period ranging from ten days to two years. We believe that careful neurolysis will enable the decrease of postoperative nerve complications. In cases with high penetration of the musculocutaneous nerve to the conjoined tendon, we pass it below only the proximal two thirds of the subscapularis muscle to diminish the tensive force, which acts on the nerve.
