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DVD-1090_006 | A | Distal Clavicle Resection

Stephen S. Burkhart

Human

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

Eine Videoaufnahme einer Operationsanleitung an einem lebenden Patienten oder Patientin in einem Operationssaal oder eine Demonstration an einem Humanpräparat.

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Gravação em vídeo de uma técnica cirúrgica em um paciente em uma sala de cirurgia ou uma demonstração cadavérica.

Vídeos de técnicas cirúrgicas

Grabación en vídeo de una técnica quirúrgica de un paciente en un quirófano o una demostración cadavérica.

Videos de técnicas quirúrgicas

Distal Clavicle Resection

So now I'm going to go back to a posterior viewing portal. And so now we're going to do our distal clavicle excision. Now that anterior mid-lateral portal that we made, our standard anterior portal is usually exactly in line with the AC joint. So you see it is this time as well. So you see we've got our 30 degree scope back right alongside the scapular spine. And that's how we get this view. And then we're going to switch over a little bit to a 70 degree scope. We'll just make a little provisional cut here first. And I want to end up with about a one centimeter space at the AC joint when we're done. I don't necessarily take away a centimeter of bone. I just want a one centimeter space. Now, the great thing about using the 70 degree scope is that regardless of the obliquity of the AC joint, you can always see to the very top of the distal clavicle, you can see its superior cortex, and you've got a lot of versatility. I'll show you in a minute when you want to see more posterior, because you can rotate your light cable so you see back more posterosuperior. So you really have this huge ability to change your field of view with a 70 degree scope and see the whole thing. Now you see, this particular joint has a significant obliquity to that medial acromial facet, and there's no way you could see the top of the distal clavicle if you didn't have a 70 degree scope, unless you put your scope in from the front. And that has its own set of problems. Now, this width of this shaver is 4.5mm. So we want a little more than two shaver blade widths as our final space here. And basically we have two bur widths that we've taken all the way back. And now you can see this poster superior part. So now we'll just kind of complete this contour it out and then come all the way back to the posterior cortex. You can end up leaving a little rim of bone in that posterior cortex if you're not careful. So always take my cautery. And I'd like to take those posterior ligaments down to be sure we haven't left anything because you still have strong attachments obliquely back. Plus we've got the superior ligaments, which are by far the most important for stabilizing the AC joint. So as long as I've got my superior ligaments basically intact, I'm satisfied. There is our distal clavicle excision right there. We'll put this instrument in for scale.

Distal Clavicle Resection

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