Shoulder-Surgical Approaches

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Approach Skin incision Superficial interval Deep interval Risks
Anterior(Henry)

10-15cm incision in line of delto-pectoral groove from tip of coracoid or

anterior axillary skin fold incision

deltoid (axillary)& pectoralis major ( medial and lateral pectoral ) Medial retraction of conjoint tendon or coracoid tip osteotomy
+
subscapularis tenotomy
+
glenohumeral capsulotomy
Musculocutaneus nerve

axillary nerve

second part of axillary artery

Cephalic vein
Anterolateral transverse, from anterolateral corner of acromion to just lateral to coracoid process detach deltoid from AC joint & 1cm of anterior aspect of acromion +
split deltoid for 5 cm
detach coracoacromial ligament from both ends & excise
Axillary nerve
Lateral 5cm long incision from the tip of the acromion down the lateral aspect of the arm split deltoid in line with its fibres from acromion down for 5 cm

acromion could be split in coronal plane to expose full length of supraspinatus

Axillary nerve lies 7cm from  tip of the acromion
Posterior linear incision along  entire length of spine of scapula extending to posterior corner of acromion detach deltoid from scapular spine +
develop plane in deltoid & infraspinatus +
retract deltoid inferiorly
teres minor (Axillary) & infra-spinatus (Supra-scapular) Axillary nerve & posterior circumflex artery in quadrangular space

suprascapular nerve

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