ABORDAJE DELTOPECTORAL PDF

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The anterior deltopectoral approach can be deltopectora, for almost any proximal humeral fracture treatment and is often the preferred approach. Close the deltopectoral groove, the subcutaneous tissues and the skin.

Take care regarding the musculocutaneous nerve and underlying brachial plexus.

Retractors placed under the conjoined tendon can cause neuropraxia; therefore vigorous retraction must be avoided. Evaluate the fracture morphology. How important is this topic for clinical practice? Indication The anterior deltopectoral approach can be used for almost any proximal humeral fracture treatment and is often the preferred approach.

The musculocutaneous nerve enters the coracobrachialis muscle as close dwltopectoral 2. Identify the coracoid process and the conjoined tendon. Overview this approach can be a fairly extensile exposure, allowing access to the anterior, medial, and lateral aspects of the shoulder.

Shoulder Anterior (Deltopectoral) Approach – Approaches – Orthobullets

L6 – years in practice. In any case, the cephalic vein should be preserved in order to reduce the surgical edema of the limb. Indication The anterior deltopectoral approach can be used for almost any proximal humeral fracture treatment and is often the preferred approach.

The musculocutaneous nerve enters the coracobrachialis muscle as close as 2. The sulcus is slightly more pronounced and in cases of revision surgery less scared. Further neurovascular structures, eg, the brachial plexus, are only at risk if there is a rigorous retraction. Expose the proximal humerus and confirm the anatomical landmarks subscapularis tendon, lesser tuberosity, bicipital groove with the bicipital tendon and the greater tuberosity.

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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.

Satisfactory reduction of anatomical neck fractures eg, C1. Retractors placed under the conjoined tendon can cause neuropraxia; therefore vigorous retraction must be avoided.

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 coracoid process, which is usually more easily palpable a cm incision is usually 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.

The coracoid is repaired with a screw or sutures placed through the drill hole. 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. Bluntly dissect between and under the deltoid and pectoralis muscles down to expose the clavipectoral fascia.

Hemorrhagic bursa tissue has to be resected if needed. The Shoulder Anterior Deltopectoral Approach is indication in: Failure to find the deltopectoral groove can lead to difficulty in dissection of the deltoid and possibly to denervation of the anterior portion of the deltoid.

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Access is improved by doing an osteotomy of the coracoid process to allow reflection of the coraco-brachialis and biceps muscles. Remember the axillary nerve just distal to the subscapularis and medial to the proximal humerus.

Thank you for rating! Further neurovascular deltopectroal, eg, the brachial plexus, are only at risk if there is a rigorous retraction. Retract the cephalic vein laterally or medially, and open along the groove. Failure to find the deltopectoral groove can lead to difficulty in dissection of the deltoid and possibly to denervation of the anterior portion of the deltoid.

This approach is also highly recommend for revision surgery. Take care regarding the musculocutaneous nerve and underlying brachial plexus.

Shoulder Anterior (Deltopectoral) Approach

Indications shoulder arthroplasty proximal humerus fractures reconstruction of recurrent dislocations long head of the biceps injury septic glenohumeral joint. Make a cm long skin incision between the coracoid process and the proximal humeral shaft.

The coracoid is repaired with a screw or sutures placed through the drill hole. Hemorrhagic bursa tissue has to be resected if needed. The sulcus is slightly more pronounced and in cases of revision surgery less scared.

Core Tested Community All. The subscapularis tendon is identified and divided vertically lateral to the musculotendinous junction.