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Open Bankart Revisited
Ryan P. Coughlin, M.D., F.R.C.S.C., Andrew Crapser, M.D., M.H.Sc., Kyrstin Coughlin, B.Sc., Larry P. Coughlin, M.D., F.R.C.S.C. Arthroscopy Techniques Volume 6, Issue 1, Pages e233-e237 (February 2017) DOI: /j.eats Copyright © 2016 Arthroscopy Association of North America Terms and Conditions
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Fig 1 (A) Left shoulder preoperative skin marking shows the low anterior axillary crease incision used for the deltopectoral (Delt/Pect) approach. (B) Deltopectoral interval, with the deltoid shown lateral and the pectoralis major muscle medial. Upward traction on the Gelpi self-retaining retractors is seen for improved exposure. (C) Link retractor separating the conjoined tendon medially and deltoid laterally and a sharp Hohmann retractor placed above the rotator cuff to expose the subscapularis (subscap). The subscapularis is marked showing the H-shaped incision in the middle third of the muscle and tendon leaving the superior and inferior portions intact. The vertical incision is 1 cm medial to the lesser tuberosity. (D) Stay sutures used to retract the subscapularis medially to expose the capsule. A T-shaped capsular incision is being performed, with the horizontal split extending to the glenoid rim. The vertical incision was completed 1 cm medial to the lesser tuberosity, and the superior and inferior leaflets are tagged with heavy sutures. Arthroscopy Techniques 2017 6, e233-e237DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions
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Fig 2 (A) Left shoulder showing disruption of the anteroinferior capsulolabral complex (Bankart lesion) with complete exposure of the glenoid rim. (B) Single loaded 3.0-mm SutureTak anchors (Arthrex) inserted along the glenoid rim starting inferiorly at the 7 o'clock position on a left shoulder. A blunt Hohmann retractor is placed intra-articularly above the humeral head and the Fukuda humeral head retractor gently pushes the humeral head away from the glenoid. The glenoid retractor is placed between the capsule labral lesion and glenoid neck. (C) The anterior capsulolabral tissue has been anatomically restored along the glenoid margin. (D) Link retractor positioned between the conjoined tendon medially and the deltoid laterally to allow reapproximation of the subscapularis. The stay sutures tagged in the subscapularis tendon are threaded through mayo needles and used for reattachment to the tendinous stump on the lesser tuberosity. The inferior and superior splits are repaired using no. 1 Dexon sutures with figure-of-8 stitches. Arthroscopy Techniques 2017 6, e233-e237DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions
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