Clavicular osteotomy approach for difficult shoulder surgery

• Main Authors: Khalid, Kamarul Ariffin, Mah, Edward T
• Format: Conference or Workshop Item
• Language: English
• Published: 2008
• Subjects: RD701 Orthopedics
• Online Access: http://irep.iium.edu.my/66313/16/66313%20%20Clavicular%20Osteotomy%20Approach.PDF; http://irep.iium.edu.my/66313/

The deltopectoral surgical approach has long been the workhorse for the anterior approach to the shoulder joint. It was described early in the last century by Thompson (1918) and Henry (1927). Although this approach can be used for many surgical procedures, one of its drawbacks is difficulty in exposing and visualizing the glenoid. It also gives limited access to the greater tuberosity and rotator cuff. Redfern et al (1989) has described an anterior approach to the shoulder joint that incorporates the use of a clavicular osteotomy. Using this method the deltoid muscle can be reflected away to provide better exposure without compromising its integrity. This paper reports the use of this approach in difficult shoulder cases where better exposure and visualization of the anatomy and pathology is required. Three 3 difficult shoulder conditions requiring surgical management, namely glenoid fracture reconstruction, humeral head resurfacing and reverse total shoulder arthroplasty for a revision case; using this approach are described. The advantages and disadvantages of this approach are also discussed. This is an approach that surgeons who regularly do shoulder surgery should consider as another alternative to be added to their armamentarium when dealing with difficult shoulder conditions.