gsteeves
Guest
Good Morning,
Dr did an open repair of middle glenohumeral ligament. This is from the op note. Thanks in advance for your help.
There was a positive pass through sign noted and at the attachment of the middle glenohumeral ligament to the humerus there was an avulsion of the ligament noted. At that point it was opted to proceed with an open repair.
A deltopectoral type incision was made, deepened through the subcutaneous tissue with hemostasis obtained by electrocautery. With careful blunt and sharp dissection of the cephalic vein was isolated, retracted medially and the interval between the deltoid and pectoralis major identified. Deep retractors were placed. The subscapularis muscle was longitudinally incised and retracted medially. The previously described ligament could be noted to be avulsed off the humeral neck area with some granulation tissue present. A transverse incision was made between the superior and middle glenohumeral ligaments. The insertion site was debrided with a curet and a 2.9 absorbable BioRaptor screw inserted, weaved through the defect in the middle glenohumeral ligament in horizontal mattress fashion securing the ligament to the insertional site. This appeared to correct the anterior translation of the humerus on the glenoid.
The wound was then thoroughly irrigated with the closure accomplished, approximating the subscapularis tendon back to the original site with horizontal mattress sutures of #1 Ethibond.
Dr did an open repair of middle glenohumeral ligament. This is from the op note. Thanks in advance for your help.
There was a positive pass through sign noted and at the attachment of the middle glenohumeral ligament to the humerus there was an avulsion of the ligament noted. At that point it was opted to proceed with an open repair.
A deltopectoral type incision was made, deepened through the subcutaneous tissue with hemostasis obtained by electrocautery. With careful blunt and sharp dissection of the cephalic vein was isolated, retracted medially and the interval between the deltoid and pectoralis major identified. Deep retractors were placed. The subscapularis muscle was longitudinally incised and retracted medially. The previously described ligament could be noted to be avulsed off the humeral neck area with some granulation tissue present. A transverse incision was made between the superior and middle glenohumeral ligaments. The insertion site was debrided with a curet and a 2.9 absorbable BioRaptor screw inserted, weaved through the defect in the middle glenohumeral ligament in horizontal mattress fashion securing the ligament to the insertional site. This appeared to correct the anterior translation of the humerus on the glenoid.
The wound was then thoroughly irrigated with the closure accomplished, approximating the subscapularis tendon back to the original site with horizontal mattress sutures of #1 Ethibond.