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Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position
- Source :
- JSES International, JSES International, Vol 4, Iss 1, Pp 77-84 (2020)
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background Shoulder arthroscopy can be performed with the patient in the lateral decubitus or beach-chair position, but in both cases, glenohumeral (GH) joint spaces must be increased to improve visualization and allow access of the optical instrument. The aim of this study was to determine the effects of limb setup and longitudinal traction on the opening of the GH space with patients placed in the beach-chair (dorsal decubitus) position. Methods GH spaces at 3 test points corresponding to the anatomic locations of Bankart lesions were determined indirectly from radiographic images obtained from 67 patients presenting shoulder pathology with an indication for arthroscopic surgery. Measurements were made with the operative limb in neutral rotation and positioned in relation to the coronal plane in adduction, 45° of abduction, or adduction with an axillary spacer, in each case with and without longitudinal traction. Results GH spaces were optimized at 2 of 3 test points when the operative limb was positioned in adduction or neutral rotation and manual longitudinal traction was applied with or without a polystyrene spacer placed under the axilla, but use of the spacer was essential to maximize the GH space at all 3 locations. In contrast, 45° of abduction proved to be the least appropriate position because it afforded the smallest GH space values with or without traction. Conclusion Appropriate positioning of the patient on the operating table is a critical aspect of shoulder arthroscopy. Radiographic images revealed that adducted upper-limb traction with the use of an axillary spacer in patients in the beach-chair position generates a significant increase in the GH space in the lower half of the glenoid cavity, thereby facilitating visualization and access of the optical equipment to the GH compartments.
- Subjects :
- axillary spacer
lcsh:Diseases of the musculoskeletal system
Shoulder surgery
medicine.medical_treatment
Radiography
Glenoid cavity
Article
Arthroscopy
joint instability
lcsh:Orthopedic surgery
longitudinal traction
Medicine
Orthopedics and Sports Medicine
Orthodontics
medicine.diagnostic_test
business.industry
radiographic imaging
patient positioning
Traction (orthopedics)
medicine.disease
Operating table
lcsh:RD701-811
Bankart lesion
medicine.anatomical_structure
Coronal plane
Surgery
lcsh:RC925-935
glenohumeral joint space
business
Subjects
Details
- ISSN :
- 26666383
- Volume :
- 4
- Database :
- OpenAIRE
- Journal :
- JSES International
- Accession number :
- edsair.doi.dedup.....c38d8fd98e1dbb520dffa8e2ba6997ab
- Full Text :
- https://doi.org/10.1016/j.jses.2019.11.003