– See: – Arthroscopic Reconstruction – Historic Operations – Revision Bankart Procedure – Bankart Repair: – reattachment of the capsule and glenoid labrum to the glenoid lip; – subscapularis is carefully divided to expose the capsule, and is reapproximated without any overlap or shortening; – PreOp Eval: – rotatory stress test for anterior instability; – … Read more
– Discussion: – ON THE ARTICULATIONS. by Hippocrates. – pathoanatomy: – bankart lesion – hill sachs lesion – stabilizers of the shoulder: – dynamic / muscular stabilizers – static stabilizers – anteroinferior glenohumeral ligament – references: – Pathoanatomy of first-time, traumatic, anterior glenohumeral subluxation events. – mechanism of anterior dislocations: – combination of abduction, … Read more
– See: – Arteries of the Upper Limb – Anatomy: – branch of axillary artery – smaller than PHCA; – passes laterally around front of surgical neck of the humerus – major blood supply to humeral head is from AHCA; – humeral head is … Read more
– See: – Anterior Approach to the Shoulder – Discussion: – with plate fixation of the humerus, the anterior approach is preferred for proximal and mid-diaphyseal frx w/ application of plate to anterolateral aspect of the humerus (see humeral shaft fractures); – interval lies … Read more
– See: Anterior Approach to the Humerus Axillary Approach: Posterior Approach Posterior Approach to Humerus Surgical Approach for Proximal Humeral Fractures Positioning and Draping: supine or beach chair; small soft bolster is placed beneath the shoulder blades to protract the shoulder; head is stabilized to prevent hyperextension and subsequent brachial plexus palsy; place patient in … Read more
PreOp Planning consider NG tube and foley catheter; have proper sized C-collar available for post operative care; position: supine w/ halter cervical traction (3-5 lbs) w/ head turned slightly to the right; consider placing a rolled towel between the shoulder blades; prep for iliac crest bone graft; hall burr is helpful for shaping bone graft; … Read more
– See: Rotator Cuff Tear – Discussion: – see abductors of the shoulder; – common tendon covering top, front, & back of humeral head; – 4 muscles fuse to form this tendon: (subscapularis, supraspinatus,, infraspinatus, teres minor;) – supraspinatus – lies … Read more
Discussion proximal humerus ossifies from four centers: head, shaft, and both tubercles, which unite at age 19 to 20; frx in adult life tend to occur along old epiphyseal lines; depression between tubercles, bicipital groove, contains long head of biceps; tubercles also serve as points of insertion for rotator cuff, w/ subscapularis inserting on lesser … Read more
Anatomy & Sites of Compression of Cubital Tunnel – Discussion: – cubital tunnel extends from medial epicondyle to olecranon; – it serves as the major contraint for the ulnar nerve as it passes behind the elbow; – w/ flexion the cubital tunnel becomes taunt, and with extension the cubital tunnel becomes lax; – aponeurotic roof … Read more
vascular supply to the humeral head Two Part Articular Segment Displacement fracture plane is through the anatomic (not surgical neck); anatomic neck represents the old eiphyseal plate; surgical neck represents the weakened area below the tuberosities and head approximately 2 cm distal to the anatomic neck; significant chondral defects and minimally separated fragments may go … Read more