Judet to Scapula

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Topic updated on 11/10/12 12:48pm
Introduction
  • Overview
    • a fairly limited exposure, allowing little anterior exposure.
  • Indications
    • proximal humerus fracture-dislocations (posterior)
    •  scapula fractures
Internervous plane
  • Internervous plane between
    • suprascapular nerve (infraspinatus) and 
    • axillary nerve (teres minor)
Approach
  • Incision
    • the patient is prone for this approach.
    • an incision is made following at the posterolateral lip of the acromion, extends along the spine of the scapula, and turns at a right angle inferiorly along the medial border of the scapula.
  • Superficial dissection
    • the posterior deltoid is elevated off the spine of the scapula.
  • Deep dissection
    • the underlying infraspinatus is elevated off the medial border of the scapula and retracted laterally on its suprascapular neurovascular pedicle, while care is taken to protect the pedicle.
Dangers
  • Suprascapular nerve and artery
    • at risk when retracting the infraspinatus

 

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