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Hemorrhagic bursa tissue has to be resected if needed. A Coracoid process B Proximal humeral shaft on the level of the axilla. Identify the coracoid process and the conjoined tendon. Access is improved by doing an osteotomy of the coracoid process to allow reflection of the coraco-brachialis and biceps muscles.

Internervous plane deltoid muscle axillary nerve. A Coracoid process B Proximal humeral shaft on the level of the axilla.

For an arthroplasty, a rather vertical incision may be preferred dashed line. 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. The coracoid is repaired with a screw or abotdaje placed through the drill hole. Bluntly dissect between and under the deltoid and pectoralis muscles down to expose the clavipectoral fascia. Please vote below and help us build the most advanced adaptive learning platform in medicine The complexity of this topic is appropriate for?

Evaluate the fracture morphology. Take care regarding the musculocutaneous nerve and dwltopectoral brachial plexus. Retract the deltoid muscle laterally using a delta modified Hohmann retractor and the conjoint tendon medially using a Langenbeck retractor. Core Tested Community Eeltopectoral. Indication The anterior deltopectoral approach can be used for almost any proximal humeral fracture treatment and is often the deltoppectoral approach.

Hemorrhagic bursa tissue has to be resected if needed. The anterior deltopectoral approach can be used for almost any proximal humeral fracture treatment and is often the preferred approach.

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Overview this approach can be a fairly extensile exposure, allowing access to the anterior, medial, and lateral aspects of the shoulder. The musculocutaneous nerve enters the biceps cm distal to the coracoid process; retraction of the conjoint tendon must be done with care.

Remember the axillary nerve just distal to the subscapularis and medial to the proximal humerus.

abordaj Access is improved by doing an osteotomy of the coracoid process to allow reflection of the coraco-brachialis and biceps muscles. The subscapularis tendon is identified and divided vertically lateral to the musculotendinous junction.

Drill the coracoid first for later fixation. In any case, the cephalic vein should be preserved in order to reduce the surgical edema of the limb.

This approach is also highly recommend for revision surgery. Further neurovascular structures, eg, the brachial plexus, are only at risk if there is a rigorous retraction.

Reflect the subscapularis from the underlying joint capsule and enter the joint through a vertical capsulotomy, medial to the lateral stump of subscapularis. Take care regarding the musculocutaneous nerve and underlying brachial plexus. Remember the axillary nerve just distal to the subscapularis and medial to the proximal humerus.

Retractors placed under the conjoined tendon can cause neuropraxia; therefore vigorous retraction must be avoided.

Shoulder Anterior (Deltopectoral) Approach

Placement of a drainage underneath the deltoid muscle might deltopecroral considered. Bluntly dissect between and under the deltoid and pectoralis muscles down to expose the clavipectoral fascia. The sulcus is slightly more pronounced and in cases of revision surgery less scared.

The arthrotomy is repaired by suture closure of the capsule and then the subscapularis.

AO Surgery Reference

How important is this topic for clinical practice? The sulcus is slightly more pronounced and in cases of revision surgery less scared.

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How important is this topic for board examinations? Identify the coracoid process and the conjoined tendon. Deltopectoeal the deltoid muscle laterally using a delta modified Hohmann retractor and the conjoint tendon medially using a Langenbeck retractor. Indication The anterior deltopectoral approach can be used for almost any proximal humeral fracture treatment and is often the preferred approach.

Failure to find the deltopectoral groove can deltopectkral to difficulty in dissection of the deltoid and possibly to denervation of the anterior portion of the deltoid. Indications shoulder arthroplasty proximal humerus abordzje reconstruction of recurrent dislocations long head of the biceps injury septic glenohumeral joint. L6 – years in practice. Satisfactory reduction of anatomical neck fractures eg, C1.

Drill the coracoid first for later fixation. The anterior deltopectoral approach can be used for almost any proximal humeral fracture treatment and is often the preferred approach.

The subscapularis tendon is identified and divided vertically lateral to the musculotendinous junction. Expose the proximal humerus and confirm the anatomical landmarks subscapularis tendon, lesser tuberosity, bicipital groove with the bicipital tendon and the greater tuberosity.

This approach is also highly recommend for revision surgery.

Further neurovascular structures, eg, the brachial plexus, are only at risk if there is a abordjae retraction. Make a cm long skin incision between the coracoid process and the proximal humeral shaft.