Shoulder Anatomy

What is the ossesus anatomy of the shoulder

Humerus

Clavicle

Scapula

Name the 3 ossesus landmarks of the Humerus

Greater Tuberosity

Lesser Tuberosity

Anatomical Neck

Greater Tuberosity

Large bulge lateral, 3 rotator cuffs attach

Clavicle muscles that attach

Trapezius, superior

Deltoid, anterior and lateral

Pectoralis Major, Inferior

Humerus muscles that attach

Deltoid, anterior and lateral

What 3 rotator cuff muscles attach to the greater tuberosity

Supraspinatus

Infraspinatus

Teres Minor

Lesser tuberosity

Small bulge on anterior, 1 rotator cuff attached

What rotator cuff muscle attaches to the lessser tuberosity

Subscapularis

Surgical neck of the humerus

Where the head meets the body

Anatomical neck of the humerus

Where the head meets the tubercules

Ossesus landmarks of the scapula

Coracoid process

Acromion

Glenoid

Coracoid process

Short head of bicep attachment, clavicular ligaments attach

Acromion

Protects the rotator cuff, can develop bone spurs that damage rotator cuff

Glenoid

Humerus sits inside glenoid, attaches long head of biceps, attaches labrum

Gleno-humeral capsule

Tough outer layer, soft tissue stability, synovial fluid

Labrum

Fibro-cartilage ring, provides stability, deepens glenoid socket

3 gleno-Humeral ligaments

Superior gleno-humeral ligament (SGHL)

Middle gleno-humeral ligament (MGHL)

Inferior gleno-humeral ligament (IGHL)

4 rotator cuff muscles

Supraspinatus

Infrasspinatus

Teres Minor

Subscapularis

Subscapularis tendon (function, attachment, movement)

Anterior support, attach lesser tuberosity, fibers connect greater tuberosity and support biceps long head, internal rotation

Supraspinatus tendon (function, attachment, movement)

Inferior to AC joint cora. ligaments, attach greater tuberosity, abduction

Infrapsinatus and Teres Minor (function, attachment, movement)

Prevents dislocations, attach greater tuberosity, external rotation

4 types of rotator cuff tears

Crescent tears

U shape tears

L shape tears

Reverse L tears

Crescent tears

minimal medial retraction

U shape tears

crescent tear with major medial retraction

L shape tear

U shape tear with longitudinal split posteriorly

Reverse L tear

U shape tear with longitudinal split anteriorly

Inter-substance tear:

Difficult to see on MRI and anthroscopically

Full thickness tear:

Prone to retraction, acute repair needed

P.A.S.T.A. Lesions

Partial

Articular-sided

Supraspinatus

Tendon

Avulsion

2 types of surgical positioning

Beach chair

Lateral decubitus

Beach chair positioning:

Deltopectoral approach, lowers venous pressure and bleeding

Lateral decubitus:

Joint dislocation, can result in neuropraxia

3 portal placements and purposes:

Posterior for viewing

Anterior for viewing

Lateral for viewing and insertions

2 nerves to avoid in portal placement and placement of risk

Axillary nerve, posterior inferior

Suprascapular nerve, posterior medial

Single Row Repair

Knotless repair with SpeedFix and/or RipStop

Steps for a SpeedFix repair

Double-Row Knotless Repair

Medium to large tears, minimizes crepidus, protects healing zone

Knotless FiberTak SpeedBridge