ortho1991
Guru
Phyician did Open revision RTC repair 23412 with Open revision Deltoid repair with advancement/transfer I'm looking at 23395 for the Deltoir repair with advancement/transfer.
Here is part of the op-note any advice or suggestions with be appreicated.
Here is part of the op-note
Using the Tornier ArthroTunneler, I placed the 3 bone tunnels after I abraded
the footprint from the articular surface out laterally 3 transosseous tunnels
were then made. I then passed to my most posterior tunnel an Arthrex
FiberTape and then two 3/4 size Tornier Force Fiber. The center hole was then
placed. I shuttled through after passing the FiberTape just at the
musculotendinous junction in a mattress fashion. The medial arm was then
brought down through the tunnel with another Force Fiber and then the other
arm placed through the center tunnel was also another FiberTape. This
FiberTape was then brought through for second more anterior medial mattress
such as the entire rotator cable and then brought down with 2 Fiber Tapes with
2 medial mattress through bone tunnels. The anterior tunnel also had 2 Force
Fibers, 3/4 size, flat sutures as well. From here, I then brought them
through bilateral tunnels and then placed three through each lateral tunnel, I
used the Tornier peek button ____ prevent cutout and more stability of the
repair. I first then with the arm in slight abduction was able to cinch down
the FiberTape with excellent compression of the cuff down to bone. Prior to
doing this, however, all five simple sutures were brought through in a
ripstops over top of the FiberTape 2 mattresses. I then cinched down my 2
mattresses and tied down on between the bone bridges and the 3 peek washers
laterally with excellent compression of the tendon down to bone from the
medial footprint. I then brought all five simples locked over the top with
excellent stability and compression anatomic repair of the rotator cuff. In
addition, when I opened this up, the biceps itself was quite shredded and torn
especially as it went out through the bicipital groove. Therefore, it was
released off the superior labrum and then through my deltopectoral incision, I
then performed a subpectoral biceps tenodesis using the Arthrex button
unicortically placing multiple about 2-3 cm of the FiberWire whipstitched into
the tendon and then locked into place. With this in place, I then
subsequently placed three drill holes through the acromion and then actually
through the soft tissue at the AC joint. These were #5 Ethibonds. They were
then placed in Mason-Allen fashion medial to the ripstop stitch in the
anterior deltoid to roll and advance the deltoid back to its normal native
position on the acromion.
Here is part of the op-note any advice or suggestions with be appreicated.
Here is part of the op-note
Using the Tornier ArthroTunneler, I placed the 3 bone tunnels after I abraded
the footprint from the articular surface out laterally 3 transosseous tunnels
were then made. I then passed to my most posterior tunnel an Arthrex
FiberTape and then two 3/4 size Tornier Force Fiber. The center hole was then
placed. I shuttled through after passing the FiberTape just at the
musculotendinous junction in a mattress fashion. The medial arm was then
brought down through the tunnel with another Force Fiber and then the other
arm placed through the center tunnel was also another FiberTape. This
FiberTape was then brought through for second more anterior medial mattress
such as the entire rotator cable and then brought down with 2 Fiber Tapes with
2 medial mattress through bone tunnels. The anterior tunnel also had 2 Force
Fibers, 3/4 size, flat sutures as well. From here, I then brought them
through bilateral tunnels and then placed three through each lateral tunnel, I
used the Tornier peek button ____ prevent cutout and more stability of the
repair. I first then with the arm in slight abduction was able to cinch down
the FiberTape with excellent compression of the cuff down to bone. Prior to
doing this, however, all five simple sutures were brought through in a
ripstops over top of the FiberTape 2 mattresses. I then cinched down my 2
mattresses and tied down on between the bone bridges and the 3 peek washers
laterally with excellent compression of the tendon down to bone from the
medial footprint. I then brought all five simples locked over the top with
excellent stability and compression anatomic repair of the rotator cuff. In
addition, when I opened this up, the biceps itself was quite shredded and torn
especially as it went out through the bicipital groove. Therefore, it was
released off the superior labrum and then through my deltopectoral incision, I
then performed a subpectoral biceps tenodesis using the Arthrex button
unicortically placing multiple about 2-3 cm of the FiberWire whipstitched into
the tendon and then locked into place. With this in place, I then
subsequently placed three drill holes through the acromion and then actually
through the soft tissue at the AC joint. These were #5 Ethibonds. They were
then placed in Mason-Allen fashion medial to the ripstop stitch in the
anterior deltoid to roll and advance the deltoid back to its normal native
position on the acromion.