Deltoid Split (Mckenzie) Approach To The Shoulder

Description

This video presentation by Bijayendra Singh provides a thorough demonstration of the deltoid split approach, primarily used for the fixation of proximal humerus fractures and also applicable for shoulder replacement surgeries, particularly reverse shoulder replacements. The procedure begins with the patient positioned in a beach chair setup, during which the speaker emphasizes the importance of marking anatomical landmarks, particularly the acromion and the incision site approximately 6 to 7cm from the lateral edge of the acromion to avoid injury to the axillary nerve.



The surgical approach involves careful skin and deep fascia incision to access the underlying muscles. Adequate hemostasis is essential, and thick flaps of skin are lifted to facilitate further dissection. The deltoid muscle is accessed through a methodical incision and dissection, allowing visibility of the acromion and associated structures.



Key steps include the use of an osteotome to perform an acromion osteotomy and an important focus on the identification of the axillary nerve, ensuring not to cause damage during the procedure. The presentation includes tips on proper suturing techniques when stabilizing the fractured fragments and the importance of excising any thick bursa to enhance exposure during the fixation process.



Throughout the video, Singh highlights techniques for manipulating fractured humerus fragments, placing stay sutures effectively, and ensuring a clear understanding of the surgical anatomy involved in this advanced orthopedic procedure.

Specialties