Three shoulders of so called “Loose shoulder” in two cases were reported. The humeral head of each shoulder was loosely dislocated inferiorly from glenoid cavity with enlarged capsule, so that active elevation of the shoulder was impossible. These were rated as the third type by Endo's grading system. Soon after glenoid osteotomy and pectralis major transfer, looseness of the shoulders recured. To obtain strong stabilization of the humeral head in glenoid cavity, we deviced biceps tenodesis of humeral head by simply modified procedure after Nicola.
Case 1. 16 years old girl.
Glenoid osteotomy and pectralis major transfer were performed on her left shoulder, but looseness was not improved completely. Failing to obtain any stability after pectralis major transfer on her right shoulder, we performed biceps tenodesis and finally obtained stability on her right shoulder.
Case 2. 18 years old girl.
We performed biceps tenodesis with pectralis major transfer on her left shoulder and obtained sufficient stability.
In conclusion, good stability could be obtained by biceps tenodesis combined with the conventional precedure such as glenoid osteotomy or pectralis major transfer on severe loose shoulders.
