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Placement of aboedaje drainage underneath the deltoid muscle might be considered. This approach is also highly recommend for revision surgery. Satisfactory reduction of anatomical neck fractures eg, C1.
Thank you for rating! Access is improved by doing an osteotomy of the coracoid process to allow reflection of the coraco-brachialis and biceps muscles.
Shoulder Anterior (Deltopectoral) Approach
Identify the coracoid process and the conjoined tendon. The Shoulder Anterior Deltopectoral Approach is indication in: The musculocutaneous nerve enters the coracobrachialis muscle as close as 2.
Remember the axillary nerve just distal to the subscapularis and medial to the proximal humerus. The coracoid is repaired with a screw or sutures placed through the drill hole.
Make a cm long skin incision between the coracoid process and the proximal humeral shaft. For an arthroplasty, a rather vertical incision may be preferred dashed line. Expose the proximal humerus and confirm the anatomical landmarks subscapularis tendon, lesser tuberosity, bicipital groove with the bicipital tendon and the greater tuberosity. Incision an incision is made following the line of the deltopectoral groove In obese patients, this may be difficult to palpate; the incision starts at the deltopecgoral process, which is usually abotdaje easily palpable a cm incision is deotopectoral utilized, but is sized according to surgical need and size of patient Superficial dissection attention must be paid to superficial skin vessels, as these can bleed significantly the deltopectoral fascia is encountered first ; the cephalic vein is surrounded in a layer of fat and is used to identify the interval the cephalic vein can be mobilized either medially or laterally, depending on patient factors and surgeon preference.
Please vote below and help us build the most advanced adaptive learning platform in medicine The complexity of this topic is appropriate for? Identify the coracoid process and the conjoined tendon. The sulcus is slightly more pronounced and in cases of revision surgery less scared. This approach is also highly recommend for revision surgery. The musculocutaneous nerve enters the coracobrachialis muscle as close as 2.
Incise the clavipectoral fascia lateral to the conjoined tendon and inferior the coracoacromial ligament. The musculocutaneous nerve enters the biceps cm distal to the coracoid process; retraction of the conjoint tendon must be done with care.
Shoulder Anterior (Deltopectoral) Approach – Approaches – Orthobullets
Bluntly dissect between and under the deltoid and pectoralis muscles down to expose the clavipectoral fascia. Please login to add comment. Indications shoulder arthroplasty proximal humerus fractures reconstruction of recurrent dislocations long head of the biceps injury septic glenohumeral joint.
A Coracoid process B Proximal humeral shaft on the level of the axilla. Reflect the subscapularis from the underlying joint capsule and enter the joint through a vertical capsulotomy, medial to the lateral stump of subscapularis.
If retracted laterally, the anatomical drainage of blood from the deltoid muscle is respected but it is at risk of damage by retractors during surgery. Expose the proximal humerus and confirm the anatomical landmarks subscapularis tendon, lesser tuberosity, bicipital groove with the bicipital tendon and the greater tuberosity. Indication The anterior deltopectoral approach can be used for almost any proximal humeral fracture treatment and is often the preferred approach.
Internervous plane deltoid muscle axillary nerve.
Remember the axillary nerve just deltopetoral to the subscapularis and medial to the proximal humerus. Retract the cephalic vein laterally or medially, and open along the groove. How important is this topic for board examinations? In any case, the cephalic vein should be preserved in order to reduce the surgical edema of the limb.
Take care regarding the musculocutaneous nerve and underlying brachial plexus. The anterior deltopectoral approach can be used for almost any proximal humeral fracture treatment and is often the preferred approach.
Anatomical landmarks for the anterior deltopectoral approach are: Close the deltopectoral groove, the subcutaneous tissues and the skin.