Open Cuff Repair - GT Relocation

Description

In this detailed presentation by Bijayendra Singh, viewers are guided through the complex procedure of open rotator cuff repair for a traumatic tear resulting from a shoulder fracture dislocation. The case involves a 58-year-old male patient who experienced a seizure-induced fall leading to significant shoulder injury. Initially, poor radiographs indicated a fractured shoulder, which later revealed a displaced greater tuberosity and a small bony labral injury confirmed through a CT scan.



As the surgery approaches, Singh emphasizes meticulous planning, including marking incisions and assessing the anatomy to avoid complications, such as damaging the axillary nerve. He discusses the challenges posed by post-injury stiffness and the necessity of restoring movement prior to surgery. The surgical procedure includes raising thick flaps, making incisive cuts with precision, and debriding excessive bursa formed after trauma.



Throughout the operation, Singh demonstrates how to handle the deltoid muscle, the importance of achieving a tension-free repair of the rotator cuff by utilizing anchors to suture the greater tuberosity, and the preparation required to strengthen the repair. The entire process is illustrated with practical insights on how to prevent common surgical pitfalls, ensuring the optimal positioning of bony fragments before final closures.



The postoperative phase emphasizes rehabilitation, where Singh encourages immediate gentle movements, progressing to more active exercises in the following weeks, with expectations for a complete range of motion by three months post-surgery. This instructional video serves not only as a surgical guide but also as a resource for understanding recovery expectations after such intricate procedures.

DOI: 10.1302/3114-221895

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