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DVD-1090_011 | A | Revision Distal Clavicle Resection

Stephen S. Burkhart

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Revision Distal Clavicle Resection

I know we need to do distal clavicle because he was very tender at the AC joint. Had pain with horizontal adduction there. Scapular spine looks like the keel of a boat. So that's got to be cleaned out enough that I can park my scope back here and look up at the AC joint. Now this man has had a failed distal clavicle excision. And if you look at the here's his medial facet of the acromion, it's the right shoulder. And then this is his distal clavicle. And you see how far it's beveled inferiorly. But then up top I think there's we're going to probably find that there's some upper part of the distal clavicle that is still left. But I think what happens in a case like this, particularly with the lateral viewing portal, you tend to continue cutting on what you can see. And you can't really see up here. And I think if you use a 70 degree scope, you're not going to have this happen to you. Okay, I'm going to have with two scopes in here, I'm going to show you where you want to be with that 70 degree scope when you're doing a distal clavicle excision. Okay. So here's my scope. It's a 70 degree scope. And we're looking upward. Here's that distal clavicle that's overly beveled. And we're looking straight up there with our 70 degree scope. Now you want to see where that is relative to the to the scapular spine that keyhole like structure. It's right there. So I've got my 70 degree scope right up against the scapular spine close to where it where it joins the acromion. And we're looking up at the AC joint right there. Here's how. This is the view that you get with a 70 degree scope. So there's our AC joint. We're looking straight up with a 70 degree scope. And now you can see we've gotten this proximal part of the distal clavicle out of there. And so there's a very nice space there. And you can see with a 70 degree scope we can see the anterior cortex superior cortex. We can rotate our light cable around and we can see the posterior cortex very nicely. Now let's look at this. Now that's where the posterior ligaments come in. Sometimes there can be some bone that's hidden back in those posterior ligaments. But you see how well posteriorly you can see. Now unless you take some of these posterior ligaments down, you're not going to be able to see the posterior cortex. So here's posterosuperior cortex of the distal clavicle. So here's posterior posterior superior superior and or superior anterior. So you can see. And then we can just rotate it around and get the best view. The other thing you can see is just the angle of the medial facet. In some patients you can get this sort of a ski slope medial facet of the acromion. And so you can use your 70 degree scope to look at that. And be sure that you have a one centimeter space all the way from top to bottom.

Trauma Upper Extremities

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Klavikulaplatten und -schrauben

Revision Distal Clavicle Resection

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Trauma Upper Extremities

Klavikulaplatten und -schrauben

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