Allard R, Fitoussi F, Azarpira MR, et al. - In patients of brachial plexus birth injury (BPBI) with internal rotation (IR) contracture of the shoulder, release of the subscapularis muscle may be performed proximally, from the subscapular fossae, or distally, along with peri-articular soft-tissues anterior to the glenohumeral joint. It was hypothesized that the indication of each strategy depends primarily on patients’ bone remodeling potential and peri-articular soft-tissue contractures, conducting proximal releases in cases younger than 4 years of age and peri-articular distal releases in older cases. Researchers here examined the outcomes achieved with such strategy. From 2012 to 2018, they identified 28 children presenting with BPBI-related shoulder IR contractures who underwent a subscapularis release; in addition, the infraspinatus was systematically reanimated with a tendon transfer (ie, latissimus dorsi or lower trapezius) in the same operating time for restoring the joint axial balance. Outcomes suggest that in patients with great bone remodeling potential and supple peri-articular soft-tissues, satisfactory functional outcomes may be attained with performing the proximal release of the subscapularis muscle combined with axial rebalancing of the joint. In older patients, lower but still significant clinical improvements may be achieved with performing a more comprehensive release of the glenohumeral joint anterior aspect.