The Only Online Procedures Training and Reference Solution

Total Page:16

File Type:pdf, Size:1020Kb

The Only Online Procedures Training and Reference Solution Procedures Consult Enhances Patient Safety and Reduces Medical Errors from Elsevier, world’s leading provider of medical information resources. Complete list of procedures Internal Medicine Module Lumbar Epidural Injections Arthrocentesis: Elbow* Abdominal Paracentesis Lumbar Laminectomy Arthrocentesis: Knee* Arterial Blood Gas Sampling Mini incision – total hip Arthrocentesis: MCP* Arterial Cannulation Mini incision – total knee Arthrocentesis: MTP* Arthrocentesis: Ankle Minimally Invasive Plating of Pilon Fractures Arthrocentesis: Shoulder* Arthrocentesis: Elbow Open repair chronic rotator cuff tear Arthrocentesis: Wrist* Arthrocentesis: Knee ORIF distal fibular fracture (lateral malleolus) Balloon Tamponade of Gastroesophageal Varcies Arthrocentesis: MCP ORIF distal radial fracture (Colles or Smith fx) Basic Airway Management* Arthrocentesis: MTP ORIF femoral fracture Basics of Wound Management Arthrocentesis: Shoulder Osteochondral Allograft Cardioversion* Arthrocentesis: Wrist Osteochondral Autograft Coaptation Splint* Basic Airway Management Osteochondral Cartilage Repair Compartment Syndrome Evaluation Cardioversion Osteotomies for Hallux Valgus Correction Cricothyrotomy Percutaneous Fixation of Proximal Slipped Capital Central Venous Catheterization: Femoral Approach Defibrillation* Femoral Epiphysis Central Venous Catheterization: Internal Dental Nerve Blocks Plateing of humeral shaft fractures Jugular Approach Digital Nerve Block Posterior spinal instrumentation – scoliosis Central Venous Catheterization: Subclavian Approach Dislocation Reduction of the Ankle Cerumen Removal Proximal Tibial Plateau Fractures Shoulder Arthroscopy (decompression, acromioplasty) Dislocation Reduction of the Elbow Joint Coaptation Splint Dislocation Reduction of the Hip Joint Defibrillation Shoulder Hemiarthroplasty Dislocation Reduction of the Patella Dislocation Reduction of the PIP and DIP Joints Stenosing Tenosynovitis Dislocation Reduction of PIP & DIP* Endocervical Culture Total knee arthroplasty Dislocation Reduction of the Shoulder Joint Epistaxis Management General Splinting Techniques Anesthesia Module Epistaxis Management* Incision and Drainage of an Abscess* Ankle Block Feeding Tube Placement Intravenous Cannulation Arterial Line Placement General Splinting Techniques* Local Anesthesia Awake Fiberoptic Intubation Incision and Drainage of Cutaneous Abscesses Long Arm Splint Axillary Block Intraosseous Infusion Long Leg Splint Bier Block Intravenous Cannulation* Lumbar Puncture Bullard Laryngoscopy Irrigation of the Eye Nasogastric Intubation Central Venous Line Placement Laceration Repair: Simple Interrupted Sutures Needle Thoracostomy Combined Spinal Epidural Anesthesia Laceration Repair: Tissue Adhesives Phlebotomy Digital Nerve Block Laceration Repair: Wound Tapes Pulmonary Artery Catheter** Double-Lumen Endotracheal Tube Placement Laryngeal Mask Airway Insertion Short Arm Splint Femoral Nerve Block Long Arm Splint* Short Leg Splint GlideScope Intubation Measurement of Intraocular Pressure: Tono-Pen Stapling Devices Infraclavicular Nerve Block – Ultrasound-Guided Technique Sugar Tong Splint Technique Nasogastric Intubation* Thoracentesis Intercostal Nerve Blocks Needle Thoracostomy* Thumb Spica Splint Interscalene Nerve Block Nerve Blocks of the Face Tick Removal Intraoperative Transesophageal Echocardiography Nerve Blocks of the Lower Extremities Transcutaneous Pacing Intravenous Catheter Placement Nerve Blocks of the Upper Extremities Transvenous Pacing Laryngeal Mask Airway Orotracheal Intubation: Basic Technique Ulnar Gutter Splint Laryngoscopy Phlebotomy* * Included in Emergency Medicine module Lumbar Cerebrospinal Fluid Drain Stapling Devices* ** Included in Anesthesia module Lumbar Epidural Placement Sugar Tong Splint* Mask Ventilation Tick Removal* Orthopaedics Module Nasogastric Tube Placement Transcutaneous Pacing* Paravertebral Nerve Block Arthroscopic meniscectomy Translaryngeal Jet Ventilation Popliteal Nerve Block Arthroscopic repair of SLAP lesion Transvenous Pacing* Arthroscopic rotator cuff repair Psoas Compartment Block – Ultrasound-Guided Technique Tube Thoracostomy Arthroscopic synovectomy Urethral Catheterization: Female Arthroscopic shoulder debridement Pulmonary Artery Catheterization Urethral Catheterization: Male Arthroscopically-aided ACL reconstruction Retrobulbar Nerve Block The only online procedures training Bankart repair Saphenous Nerve Block Pediatric Emergency Medicine (included) Carpal tunnel Spinal Anesthesia – Subarachnoid Block Bag-valve mask and reference solution Cervical Arthrodesis Supraclavicular Nerve Block – Ultrasound-Guided Bladder catheterization Technique Cervical Epidural Injections Impacted cerumen removal Thoracic Epidural Placement – Midline Approach Diskectomy, anterior cervical Intravenous catheterization Thoracic Epidural Placement – Paramedian Approach Providing multimedia modules designed to help improve Diskectomy, lumbar Intubation Transversus Abdominis Plane Block Distal Bicep Tendon repair Lumbar puncture patient safety, reduce medical errors and make procedures Facet injection Nursemaid’s elbow Finewire Fixator Emergency Medicine Module Passive O2 delivery Ganglion excision – wrist Arterial Blood Gas Sampling* education safer and more effective. Venipuncture Hammertoe Arterial Cannulation* IM nailing trochanteric fracture (femoral shaft) Arthrocentesis: Ankle* *Included in Internal Medicine module No-cost institutional trials at Internal Medicine • Anesthesia • Orthopaedics • Emergency Medicine ProceduresConsult.com/trial. For more information, contact us at 11830 Westline Industrial Drive ProceduresConsult.com [email protected] St. Louis, MO 63146 ProceduresConsult.com or call 877-857-1047. May 2008 Welcome to Procedures Consult, the online multimedia training and Supports healthcare organizations emphasis on standardization reference solution that helps physicians, medical residents and students prepare for, and consistency in procedural training. Procedures Consult is built on perform and test their knowledge of top medical procedures. Featured specialties learning management software and offers superior, comprehensive procedures include Internal Medicine, Anesthesia, Emergency Medicine and Orthopaedics. information optimized for consistency in training, reference and review. In addition, Procedures Consult includes: Procedures Consult is Procedures Consult helps Helps hospitals focus on enhancing patient safety through superior healthcare organizations • Customization tools to edit text to precisely fit organization needs; ideal for: staff development. Procedures Consult is designed to meet the procedural needs enhance patient safety • Medical residents and reduce the potential ability to add procedure-specific alerts and links to institutional resources of physicians through every stage of their career. Residents and students can watch • Medical students for medical errors and • Self-directed testing that saves educators valuable time by managing the videos of experts performing procedures, once or as many times as necessary, before • Practicing physicians complications: testing process online for one or a large group of trainees • Follows standards developed by performing procedures themselves. Physicians looking to maintain their skills and • Physician assistants • Tracking and reporting to monitor trainee performance and competence of the ACGME knowledge have a new, easy way to access important reference content. Procedures • Certified registered nurse assigned procedures necessary for credentialing anesthetists • Highlights patient safety Consult helps reduce the potential for medical errors and complications by guidelines consistent with • Operating room nurses providing immediate access to information on high-risk/high-volume procedures as Patient safety guidelines highlighted, as well as when patient standards established by Joint informed consent is necessary • Advanced practice nurses Commission and OSHA well as medical procedures performed infrequently that are critical to patient safety. • Respiratory therapists • Offers clinical pearls from experts on how to perform procedures Procedures Consult successfully View video and high- Summaries and complete CPT and integrates directly with: quality animation details of procedures ICD-9 codes • Allows users to customize the • MD Consult, Elsevier’s leading information/learning experience online clinical reference service that fits their knowledge needs • Leading residency management • Includes related information such software applications as indications, contraindications, anatomy, equipment and complications Procedures Consult Editors and Contributors are an experienced team • Provides references to evidence- of medical professionals from esteemed based information medical facilities. Their role is to ensure Key features unique to quality, integrity, accuracy and currency Procedures Consult: of the multimedia and text for all • Customizable content to reflect procedures. Internal Medicine module institution-specific protocols thus content developed at Mt. Auburn Hospital (Harvard Medical School). Anesthesia providing educators with control Practical module expert video and text content over clinical information presented medical tips developed with a team of 21 contributors • Single-user interface with expert from experts at University of Pennsylvania. Emergency video and instructional text Medicine module content developed at provides highly effective and tim- Mt. Auburn Hospital with text/ efficient instruction Navigate to any Step-by-step Still images and illustrations adapted from Roberts & section of video instructional text illustrations • Administrative component for Hedges, Clinical Procedures in Emergency tracking and reporting trainee or repeat specific accompany each sections procedure Caution icons Medicine, 5e. Orthopaedics module performance/competence of indicate when content developed in conjunction with assigned procedures particular care Campbell Clinic with text/illustrations should be taken adapted from Campbell’s Operative Orthopaedics, 11e. Free Trial! Give your physicians a No-Cost Trial of Procedures Consult. www.ProceduresConsult.com/trial.
Recommended publications
  • Arthroscopic Bankart Repair Is a Function Selection Patient Indication
    CLINICAL ORTHOPAEDICS AND RELATED RESEARCH Number 390, pp. 31–41 © 2001 Lippincott Williams & Wilkins, Inc. Arthroscopic Bankart Repair Experience With an Absorbable, Transfixing Implant 03/25/2020 on BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3XGJiJSDa6kLdjliRzOOsR+bI3gZWJ99pv/KNUfPjA6Y= by https://journals.lww.com/clinorthop from Downloaded Stephen Fealy, MD; Mark C. Drakos, BA; Downloaded Answorth A. Allen, MD; and Russell F. Warren, MD from https://journals.lww.com/clinorthop by 3 BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3XGJiJSDa6kLdjliRzOOsR+bI3gZWJ99pv/KNUfPjA6Y= The use of arthroscopic means to address shoul- scribed in 1938. The essential lesion of shoul- der instability has provided a technically advan- der instability, as described by Bankart, is tageous way to approach Bankart lesions while thought by many to represent the most com- posing complex questions regarding the specific mon disorder underlying possible causes for indications for such an intervention. A successful shoulder instability.2,19,31 It represents a de- outcome with arthroscopic Bankart repair is a tachment of the labrum and its osseous inser- function of proper surgical indication and pa- tient selection. Several authors have evaluated tion from the anteroinferior glenoid. Reestab- the causes of failure and reasons for success with lishing the structural integrity of the soft tissue the Suretac device. The development of a bioab- to glenoid interface is the paramount objective sorbable repair device at the authors’ institution of the Bankart repair and has an essential role was precipitated by a desire to address and re- in surgery for shoulder stability. Although the pair Bankart lesions arthroscopically while traditional open Bankart repair remains the avoiding the frequent complications associated gold standard in treatment options, continued with the metal staple and the transglenoid suture development of arthroscopic techniques and technique.
    [Show full text]
  • Coracoid Graft Union: a Quantitative Assessment by Computed Tomography in Primary and Revision Latarjet Procedure
    ARTICLE IN PRESS J Shoulder Elbow Surg (2018) ■■, ■■–■■ www.elsevier.com/locate/ymse ORIGINAL ARTICLE Coracoid graft union: a quantitative assessment by computed tomography in primary and revision Latarjet procedure Mohammad Samim, MD, MRCSa, Kirstin M. Small,MDb,*, Laurence D. Higgins, MD, MBAc aDepartment of Radiology, NYU Langone Medical Center, New York, NY, USA bDepartment of Radiology, Brigham and Women’s Hospital, Boston, MA, USA cBoston Shoulder Institute, Boston, MA, USA Background: The goal of the Latarjet procedure is restoration of shoulder stability enabled by accurate graft positioning and union. This study aimed to establish a reproducible method of quantitatively assess- ing coracoid graft osseous union percentage (OUP) using computed tomography (CT) scans and to determine the effect of other factors on the OUP. Materials and methods: Postoperative CT scans of 41 consecutive patients treated with the open Latarjet procedure (37% primary, 63% revision) for anterior glenohumeral instability were analyzed for the OUP, position of the graft, and screw type and angle. Two musculoskeletal radiologists independently exam- ined the images 2 times, and intraobserver and interobserver reliability was calculated using intraclass correlation coefficient (ICC). Results: Mean OUP was 66% (range, 0%-94%) using quantitate methods, with good intraobserver re- liability (ICC = 0.795) and interobserver reliability (ICC = 0.797). Nonunion and significant graft resorption was found in 2 patients. No significant difference was found in the mean OUP in the primary (63%) vs. revision Latarjet procedure (67%). Grafts were flush in 39%, medial in 36%, and lateral in 8%. The medial and neutral graft position was associated with slightly higher OUP (72% and 69%) compared with lateral (65%).
    [Show full text]
  • Clinical Guidelines
    CLINICAL GUIDELINES Joint Services Guidelines Version 1.0.2019 Clinical guidelines for medical necessity review of comprehensive musculoskeletal management services. © 2019 eviCore healthcare. All rights reserved. Regence: Comprehensive Musculoskeletal Management Guidelines V1.0.2019 Large Joint Services CMM-311: Knee Replacement/Arthroplasty 3 CMM-312: Knee Surgery-Arthroscopic and Open Procedures 14 CMM-313: Hip Replacement/Arthroplasty 35 CMM-314: Hip Surgery-Arthroscopic and Open Procedures 46 CMM-315: Shoulder Surgery-Arthroscopic and Open Procedures 47 CMM-318: Shoulder Arthroplasty/ Replacement/ Resurfacing/ Revision/ Arthrodesis 62 ______________________________________________________________________________________________________ © 2019 eviCore healthcare. All Rights Reserved. Page 2 of 69 400 Buckwalter Place Boulevard, Bluffton, SC 29910 (800) 918-8924 www.eviCore.com Regence: Comprehensive Musculoskeletal Management Guidelines V1.0.2019 CMM-311: Knee Replacement/Arthroplasty CMM-311.1: Definition 4 CMM-311.2: General Guidelines 5 CMM-311.3: Indications and Non-Indications 5 CMM-311.4 Experimental, Investigational, or Unproven 9 CMM-311.5: Procedure (CPT®) Codes 10 CMM-311.6: References 10 ______________________________________________________________________________________________________ © 2019 eviCore healthcare. All Rights Reserved. Page 3 of 69 400 Buckwalter Place Boulevard, Bluffton, SC 29910 (800) 918-8924 www.eviCore.com Regence: Comprehensive Musculoskeletal Management Guidelines V1.0.2019 CMM-311.1: Definition
    [Show full text]
  • Epidemiology of Paediatric Shoulder Dislocation: a Nationwide Study in Italy from 2001 to 2014
    International Journal of Environmental Research and Public Health Article Epidemiology of Paediatric Shoulder Dislocation: A Nationwide Study in Italy from 2001 to 2014 Umile Giuseppe Longo 1,* , Giuseppe Salvatore 1, Joel Locher 1, Laura Ruzzini 2, Vincenzo Candela 1, Alessandra Berton 1, Giovanna Stelitano 1, Emiliano Schena 3 and Vincenzo Denaro 1 1 Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Rome, Italy; [email protected] (G.S.); [email protected] (J.L.); [email protected] (V.C.); [email protected] (A.B.); [email protected] (G.S.); [email protected] (V.D.) 2 Department of Orthopedics, Children’s Hospital Bambino Gesù, Via Torre di Palidoro, Palidoro, 00165 Rome, Italy; [email protected] 3 Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-06-225411613; Fax: +39-06-225411638 Received: 10 March 2020; Accepted: 17 April 2020; Published: 20 April 2020 Abstract: Limited knowledge is accessible concerning the tendencies of hospitalization for skeletally immature patients with episodes of shoulder dislocation. Our research aim was to evaluate annual hospitalizations for shoulder dislocation in paediatric patients in Italy from 2001 to 2014, on the basis of the official data source as hospitalization reports. The second purpose was to investigate geographical diversification in hospitalization for shoulder dislocation in regions of Italy. The last aim was to make statistical predictions of the number of shoulder dislocation hospitalization volumes and rates in skeletally immature patients based on data from 2001 to 2014.
    [Show full text]
  • History of Surgical Intervention of Anterior Shoulder Instability
    J Shoulder Elbow Surg (2016) 25, e139–e150 www.elsevier.com/locate/ymse History of surgical intervention of anterior shoulder instability David M. Levy,MD*, Brian J. Cole, MD, MBA, Bernard R. Bach Jr, MD Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA Background: Anterior glenohumeral instability most commonly affects younger patients and has shown high recurrence rates with nonoperative management. The treatment of anterior glenohumeral instability has undergone significant evolution over the 20th and 21 centuries. Methods: This article presents a retrospective comprehensive review of the history of different operative techniques for shoulder stabilization. Results: Bankart first described an anatomic suture repair of the inferior glenohumeral ligament and anteroinferior labrum in 1923. Multiple surgeons have since described anatomic and nonanatomic repairs, and many of the early principles of shoulder stabilization have remained even as the techniques have changed. Some methods, such as the Magnusson-Stack procedure, Putti-Platt procedure, arthroscopic stapling, and transosseous suture fixation, have been almost completely abandoned. Other strategies, such as the Bankart repair, capsular shift, and remplissage, have persisted for decades and have been adapted for arthroscopic use. Discussion: The future of anterior shoulder stabilization will continue to evolve with even newer prac- tices, such as the arthroscopic Latarjet transfer. Further research and clinical experience will dictate which future innovations are ultimately embraced. Level of evidence: Review Article © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Keywords: Anterior glenohumeral instability; dislocation; subluxation; shoulder stabilization; arthroscopic; Bankart Because of its relative lack of bony limitations and ex- Hovelius et al60 in a prospective study of 229 primary dis- tensive range of motion, the shoulder is the most commonly locations treated nonoperatively.
    [Show full text]
  • The Open Modified Bankart Procedure 1065
    Upper limb The open modified Bankart procedure OUTCOME AT FOLLOW-UP OF 10 TO 15 YEARS T. D. Berendes, We report the outcome of a modified Bankart procedure using suture anchors in 31 patients R. Wolterbeek, (31 shoulders) with a mean follow-up of 11 years (10 to 15). The mean age of the patients P. Pilot, was 28 years (16 to 39). At follow-up, the mean Rowe score was 90 points (66 to 98) and the H. Verburg, Constant score was 96 points (85 to 100). A total of 26 shoulders (84%) had a good or R. L. te Slaa excellent result. The rate of recurrence varied between 6.7% and 9.7% and depended on how recurrence was defined. Two patients had a significant new injury at one and nine From The Reinier de years, respectively after operation. The overall rate of instability (including subluxations) Graaf Groep, Delft, varied between 12.9% and 22.6%. All patients returned to work, with 29 (94%) resuming The Netherlands their pre-operative occupation and level of activity. Mild radiological osteoarthritis was seen in nine shoulders (29%) and severe osteoarthritis in one. We conclude that the open modified Bankart procedure is a reliable surgical technique with good long-term results. The common form of instability of the shoulder lisation of the shoulder between November is traumatic anterior dislocation,1 and operative 1989 and December 1993 were reviewed at a treatment is classified as anatomical or non-ana- mean follow-up of 11 years (10 to 15). None tomical. The former was first described by had multi-directional instability or previous Bankart2 in 1938 and involves reconstruction of operative procedures on the shoulder.
    [Show full text]
  • Treatment After Traumatic Shoulder Dislocation
    Review Br J Sports Med: first published as 10.1136/bjsports-2017-098539 on 23 June 2018. Downloaded from Treatment after traumatic shoulder dislocation: a systematic review with a network meta-analysis Lauri Kavaja,1,2 Tuomas Lähdeoja,1,3,4 Antti Malmivaara,5,6 Mika Paavola4 ► Additional material is ABStract Acute treatment of a dislocated shoulder is closed published online only. To view Objective To review and compare treatments (1) reduction, which should be performed as soon as please visit the journal online after primary traumatic shoulder dislocation aimed at possible, either on the field or in an emergency (http:// dx. doi. org/ 10. 1136/ 14 bjsports- 2017- 098539). minimising the risk of chronic shoulder instability and (2) department. Some patients develop recurrent for chronic post-traumatic shoulder instability. dislocations or symptomatic subluxations even in 1Medical Faculty, University of Design Intervention systematic review with random daily activities. This has prompted suggestions that Helsinki, Helsinki, Finland effects network meta-analysis and direct comparison surgical stabilisation may be indicated after the first 2Department of Surgery, South Carelia Central Hospital, meta-analyses. dislocation—a treatment strategy that has been Lappeenranta, Finland Data sources Electronic databases (Ovid MEDLINE, investigated in several randomised controlled trials 3Finnish Center of Evidence- Cochrane Clinical Trials Register, Cochrane Database (RCT), with mixed results.3 4 6 7 15 16 based Orthopaedics (FICEBO), of Systematic
    [Show full text]
  • CPG Shoulder Instability 2019 Handouts
    CSM 2019 Shoulder Instability Clinical 1/24/19 Practice Guidelines Shoulder Stability and Movement Coordination Impairments: Shoulder Instability Clinical Shoulder Instability Guideline Leaders Practice Guideline Amee Seitz and Tim Uhl Co-Leaders Amee L Seitz, PT, PhD, DPT, OCS & Timothy Uhl, PT, ATC PhD Lori Michener, PT, ATC, PhD, SCS* Support by Orthopedic Section Office (Brenda Johnson, Christine McDonouGh) and APTA and Michael Shaffer, PT, MS, ATC Linda O'Dwyer Certified Science Librarian Martin Kelley, PT, DPT Diagnosis Intervention Angela Tate, PT, PhD Clinical Course/ Prognosis Examination Section Leaders Section Leaders Section Leaders Section Leaders 2600 articles, 260 full-text 6500 titles and abstracts, Margie Olds, PT MHSC, BPHty 5000 titles/abstracts 12,300 titles /abstracts reviews 120 full text reviews Aaron Sciascia, PhD, ATC, PES Tim Uhl PhD, PT, ATC Kyle Matsel, PT, DPT, SCS, CSCS Eric HeGedus PT, DPT, PhD, OCS, Lori Michener PhD, PT, ATC, Amee Seitz PhD PT, DPT, OCS Kyle Matsel DPT, SCS, CSCS CSCS SCS, FAPTA Mike Shaffer PT, MSPT, OCS, Eric Hegedus, PT, PhD, DPT, OCS, CSCS Carolyn Hettrich MD, MPH Aaron Scisascia PhD, ATC, PES AnGela Tate PhD, PT, Cert ATC Marty Kelley PT, DPT, OCS Nitin Jain, MD, MPH MDT MarGie Olds MHSC, BPHty Carolyn Hettrich, MD, MPH DPT Students at DPT Students/ Research Orthopaedic DPT Residents Northwestern Assistants Non-authors; Nitin Jain, MD (Non-authors; acknowledGed (Non-auhtors; acknowledGed acknowledGed contributors) contributors) contributors) Disclosures Objectives of Session • All Authors have no conflicts related to 1. Explain the shoulder pain classification and methods used to categorize development of the CPG patients into shoulder CPG categories, specifically shoulder instability • Funded by the Academy of Orthopaedic Physical 2.
    [Show full text]
  • Open Latarjet Anterior Shoulder Stabilization
    UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Open Latarjet Anterior Shoulder Stabilization The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared to a golf ball on a tee. This analogy is used because the articular surface of the round humeral head (upper most part of the arm) is approximately four times greater than that of the relatively flat shoulder blade face (glenoid fossa). The stability and movement of the shoulder is controlled by Figure 1 L to R: Lateral view of glenoid post laterjay with humerous removed. Anterior view of the rotator cuff muscles, ligaments shoulder post laterjay. Two screws are fixing a bony piece of the coracoid to the front of the bony and the capsulolabral complex glenoid fossa. This increases the surface area of the “golf tee” portion of the shoulder joint and of the shoulder. The labrum is a increases its stability. fibrocartilaginous ring which attaches or the arm is stretched straight out years after the initial dislocation, to the bony rim of the glenoid fossa. from the body, such as falling on 66% of patients who were less than The labrum doubles the depth of an outstretched hand. When the 20 years old suffered a second the glenoid fossa to help provide shoulder dislocates anteriorly the dislocation while 40% of patients stability. An analogy would be a capsule, ligaments and labrum are who were between 20 and 40 years parked car on a hillside with a chop often torn. The anterior inferior part old suffered a second dislocation. block under the tire – the round tire of the labrum (located between the None of the patients older than 40 being the humeral head, the road 3 o’clock to 6 o’clock positions on years old had suffered subsequent being the glenoid fossa and the the glenoid) is the area torn with this dislocations.
    [Show full text]
  • Arthroscopic Bankart Repair with Suture Anchors: Tips for Success Kevin D
    Arthroscopic Bankart Repair With Suture Anchors: Tips for Success Kevin D. Plancher, MD,* and Stephanie C. Petterson, PhD† Anterior instability treated by arthroscopic surgery is a viable option to return the athlete and nonathlete back to activities. The use of suture-loaded anchors has become a standard method with reliable fixation. Arthroscopic Bankart repair can successfully restore range of motion and stability and yield successful outcomes with a low recurrence rate. This article describes arthroscopic Bankart repair with a modified inferior capsular shift in the lateral decubitus position. Oper Tech Sports Med 21:192-200 C 2013 Elsevier Inc. All rights reserved. KEYWORDS shoulder, anterior instability, arthroscopic Bankart, inferior capsular shift nterior instability is the most common form of shoulder A Bankart lesion is the avulsion of the glenoid labrum, with Ainstability.1 The incidence of traumatic anterior gleno- or without a bony lesion, with the anterior band of the inferior humeral instability in the general population is 1.7%,2 with the glenohumeral ligament (IGHL) from the anterior inferior incidence of Bankart lesions in first-time traumatic dislocators glenoid. The anterior band of the IGHL is the primary restraint as high as 97%.3 A patient account of a traumatic fall with a to anterior translation of the humeral head, particularly when resultant anterior dislocation documented by radiography and the shoulder is in 901 abduction and placed in an externally positive physical findings is a good indication of a Bankart rotated position.7,8 A second restraint to anterior humeral lesion. Although changes in the capsule and the glenohumeral translation is the muscular contribution of the subscapularis.
    [Show full text]
  • Open Bankart Repair: Is It Still Relevant?????
    Chicago Sports Medicine Symposium 2016 Open Bankart Repair: Is it Still Relevant????? Brian R. Wolf MD MS Congdon Professor and Vice-Chair of Orthopaedic Surgery Director of Sports Medicine Head Team Physician, University of Iowa, Iowa City, IA Photos B. Wolf personal file Disclosures . No Disclosures relevant to this presentation . Grant support: OREF, Arthrex, Smith and Nephew . Consultant: ConMed . Editorial Board: Orthopaedic Journal of Sports Medicine . Committees: Program Committee: ASES, AOSSM, MAOA Corporate Relations Committee: AOSSM BOS Fellowship Match Committee Chair: AAOS (chair) DISCLAIMER . I do the vast majority of my Scope instability surgery repair DTA arthroscopically . I also do a fair amount of glenoid bone restoration (Latarjet) procedures Open . I absolutely think there is a Bankart role for Open Bankart Repair surgery 1 Open Repair – where did it go? . Limited exposures in training . Less frequently done . New trend in shoulder instability Option A: scope repair Option B: latarjet or bone procedure WE ARE FORGETTING GOOD INTERMEDIATE OPTION – OPEN REPAIR The reality . The majority of primary instability surgery today is done arthroscopically MOON shoulder data 94 % done arthroscopic (604/640) 2/3 of revision surgery done open Latarjet > open Bankart / shift Anterior instability surgery Proper Preoperative Planning – Evaluate Glenoid Bone Loss X-ray, CT with 3D recons, +/- MRI arthrogram; +/- Arthroscopy 0 to 15% 15% to 25% > 25% Primary Repair Primary Repair OPEN bone (Scope or open) (Open or Scope) Augmentation •Incorporate Any Bony •Incorporate bony procedures Fragments if possible fragments if possible •Liberal use of anchors •± bone augmentation •+/- address Hill Sachs What was the prior procedure? Consider different technique for revision 6 2 Glenoid Track – Yamamoto 2007 .
    [Show full text]
  • Glenoid Bone Loss Management CDR Provencher MT AOSSM Specialty Day 2013 Naval Med Center San Diego
    Glenoid Bone Loss Management CDR Provencher MT AOSSM Specialty Day 2013 Naval Med Center San Diego Glenoid Bone Loss Management: Alllograft Matthew T. Provencher, MD CDR MC USN Professor of Surgery & Orthopaedics, USUHS Director Orthopaedic Shoulder, Knee and Sports Surgery Department of Orthopaedic Surgery, Naval Medical Center San Diego 34800 Bob Wilson Dr. Ste 112 San Diego, CA 92134 1. Potential Pitfalls in Any Shoulder Instability Repair Glenoid bone loss – Lots of attention in recent literature Significant Hill-Sachs lesion Revision situation – post thermal cases Revision situation with prior capsular insufficiency Prior anchor placement Error in diagnosis Rehabilitation issues and compliance Technical errors o Correct anchor placement o Proper capsular mobilization (HAGL) o RI Closure? o Prior thermal cases? o Adequate capsular tensioning – 1cm? o HAGL injuries Associated injuries o SLAP, HAGL, bony deficiencies o Neurologic injury (winging!) Boileau (JBJS 2006)4 – “Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair” o 91 patients followed prospectively o 15.3% recurrence (36 months f/u), at 17 months post-surgery o Recurrence higher in hyperlaxity, bone loss, and number of anchors (4 or more was good prognostic sign) Tauber32 – “Reasons for failure after surgical repair of anterior shoulder instability” o 41 patients followed 49 months o At revision surgery – 56% with persistent bony defect, patulous capsule 22%, laterally torn capsule 5% Glenoid Bone Loss Management CDR Provencher
    [Show full text]