coracoid transposition

Recurrent dislocation of the shoulder joint is a common complication of traumatic shoulder dislocation, which usually occurs within 2 years after the original dislocation. It often causes recurrence of shoulder dislocation when subjected to slight external force. As the dislocation recurs, the joint becomes more and more unstable. The pathological changes of this injury include the rupture of the joint capsule, the defect on the anterior lip of the scapula, and the humeral head. Posterior lateral compression fracture. There is also a non-invasive dislocation, usually the shoulder joint is normal, and the muscle can be dislocated by a slight muscle pull. This dislocation often has anatomical developmental variations. The corresponding surgical methods should be adopted according to different pathological changes in treatment. Treatment of diseases: traumatic shoulder dislocation, shoulder dislocation Indication Condylar transposition applies to: The anterior dislocation of the shoulder joint recurred frequently, and the anterior joint capsule was weak. After surgery, the biceps head and the condyle produce a strong dynamic struts in front of and below the shoulder joint, thus preventing the humeral head from dislocating during abduction and external rotation. Preoperative preparation Anesthesia and position 1. General anesthesia. 2, supine position, the shoulder of the shoulder pad is raised. First, the patient is placed in a reclining position, and the skin of the neck, shoulder, chest and back is sterilized and the sterile sheet is placed and then placed in the supine position. Surgical procedure 1. Incision The anterior medial incision of the shoulder joint reveals the anterior shoulder sleeve of the shoulder joint. 2, revealing the joint Move the chiseled tip and the attached biceps short head and diaphragm to the distal side, pay attention to protect the musculocutaneous nerve, and touch the hand to determine the nerve position. Then, the muscle abdomen was opened 1 cm at the midpoint of the superior and inferior scapular muscles. Stuff with gauze. After determining the gap between the subscapularis and the joint capsule, the incision extends horizontally from the incision until the medial edge of the biceps femoris sulcus. The scapularis muscle and its tendons are retracted up and down to expose the anterior joint capsule. Cut the switch capsule, explore the pathological changes in the joint, remove the free body, if the joint capsule and the joint lip have been separated, suture the joint capsule or fix it with barbed staples. If the humeral head affects the operation, temporarily retract it. Expose the front of the shoulder blade and prepare to transplant the condyle. The scapular neck periosteum was dissected, the soft tissue was dissected, a 3.2 cm hole was drilled in the lower part of the scapula neck, and the same diameter hole was drilled at the tip of the condyle. A suitable coarse screw was prepared to fix the condyle near the anterior humerus. 3, stitching The scapular submuscular muscle was sutured, the deltoid and pectoralis major fascia were sutured, and the incision was sutured in layers. complication 1. The musculocutaneous nerve passes through the diaphragm several centimeters below the condyle, so it is easy to damage the nerve when the muscle is turned down. 2, postoperative activities can loosen the screws that fix the condyle. Loosen loose screws if loose.

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