Coracoid process fractures
Scapular process fractures
Types
Coracoid process
Scapula spine
Acromial fractures
Coracoid process
Scapula spine
Acromial fractures
Osteoarthritis
- abnormal morphology
- loss of head neck offset
- bony impingement on acetabulum
AVN
- 85 intra-articular ganglions
- 49 ACL, 16 PCL
- 12 from anterior horn meniscus, 3 posterior horn meniscus
- 3 from fat pad
Technique
Surgical technique PDF using trans-septal portal
Deformity correction
Poor soft tissues
- prohibit ORIF
Non union
Infected non uniion
Malunion / deformity
Bone loss / bone transport / LLD
Indication
Bony defects > 30 %
Options
- Latarjet - may be insufficient for lesions in the region of 50%
- Iliac crest - associated with high incidence of OA
- distal tibial allograft - radius of curvature matches glenoid highly
https://www.vumedi.com/video/arthroscopic-double-row-subscapularis-repa…
Technique
- extra-articular
Portals
- posterior portal very lateral so can see anterior aspect subacromial space
- port of Wilminton at anterolateral acromion to access SSC
- anterior portal in normal position, slightly more lateral so becomes working portal
Engaging Hill Sachs