肩关节韧带修复.ppt

* 切口位于胸三角沟，暴露头静脉并且加以保护！ 头静脉位于胸三角沟的外侧 放置半自动拉钩，暴露深部肌肉和肱二头肌短头 暴露肩胛下结构！ 缝合切口边缘，更好的暴露肩关节囊！ 继续深部解剖！ 分离下方的关节囊！ 显示的全部关节囊！ 不可吸收缝合线将关节前侧韧带如是缝合加固！ After examination under anesthesia and local injection, the incision is made over the deltopectoral groove. The cephalic vein is identified and retracted laterally as the deltoid muscle is separated from the pectoralis major. The short head of the biceps is retracted medially exposing the underlying tendon of the subscapularis muscle and a self-retaining retractor is placed The subscapularis is carefully opened medially below the equator to identify the plane between it and the articular capsule. The incision is lengthened as the plane is developed medially. The edges of the subscapularis are retracted with sutures allowing wide blunt dissection of the plane between it and the capsule. The articular capsule is carefully opened along the same line avoiding articular injury. The inferior subscapular plane is further developed toward the redundant inferior capsule. The redundancy of the inferior portion of the shoulder articular capsule is shown. * * * After examination under anesthesia and local injection, the incision is made over the deltopectoral groove. The cephalic vein is identified and retracted laterally as the deltoid muscle is separated from the pectoralis major. The short head of the biceps is retracted medially exposing the underlying tendon of the subscapularis muscle and a self-retaining retractor is placed The subscapularis is carefully opened medially below the equator to identify the plane between it and the articular capsule. The incision is lengthened as the plane is developed medially. The edges of the subscapularis are retracted with sutures allowing wide blunt dissection of the plane between it and the capsule. The articular capsule is carefully opened along the same line avoiding articular injury. The inferior subscapular plane is further developed toward the redundant inferior capsule. The redu