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International Orthopaedics

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01-02-2015 | Original Paper

Deltopectoral approach for shoulder arthroplasty: anatomic basis

Authors: Francois Gadea, Yves Bouju, Julien Berhouet, Guillaume Bacle, Luc Favard

Published in: International Orthopaedics | Issue 2/2015

Abstract

Purpose

The deltopectoral approach is a common surgical procedure for shoulder arthroplasty. Many surgeons are familiar with this procedure, but certain steps are still controversial. This is the case for the management of subscapularis, where surgeons must choose between tenotomy and the lesser tuberosity osteotomy.

Methods

This article is conceived as a toolkit for the inexperienced surgeons, describing our tips and tricks to facilitate final exposure of the glenoid. For experienced surgeons, we analysed the tricky portions of the deltopectoral approach, comparing them with what is classically reported in the literature.

Results

We describe an original technic for subscapularis reattachment after lesser tuberosity osteotomy in order to improve its stability. The medial part of the fragment is secondarily sculpted to obtain a step shape, which will be applied against the base of the prosthetic cup in a sort of “corner buttress”.

Conclusions

Our work, based on our personal experience, confirms that there is no preferred single deltopectoral approach but, rather, multiple options. When embarking on this “shoulder highway”, we encourage surgeons to respect the successive anatomic planes, which we believe is the only way to ensure easy and atraumatic dissection.

Key points

- The safe plane for going around the humeral head and positioning retractors is the plane of the subacromial deltoid bursa.

- Always stay close to the bone during capsule release, whether on the humeral or glenoid side.

- Never go medially to the conjoint tendon or its deep face.

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Title: Deltopectoral approach for shoulder arthroplasty: anatomic basis
Authors: Francois Gadea
Yves Bouju
Julien Berhouet
Guillaume Bacle
Luc Favard
Publication date: 01-02-2015
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 2/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-014-2654-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Deltopectoral approach for shoulder arthroplasty: anatomic basis

Abstract

Purpose

Methods

Results

Conclusions

Key points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Key points

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Acknowledgement to referees