The Hip: Preservation, Replacement and Revision

Puncture of Shouler Joint & Subacromial Bursa

- Puncture of Shoulder Joint:
    - posterior approach gives easy access to glenohumeral joint & avoids risk of damaging brachial plexus or cephalic vein;
    - pt should be seated & entire shoulder, both anterior & posterior, should be prepped and draped;
    - palpate most lateral edge of the acromion process;
    - choose an entry site one cm medial and one cm distal to this;
    - w/ other hand, palpate coracoid process anteriorly;
    - now aim needle for coracoid process and it should enter joint;
- Puncture of the Subacromial Bursa:
    - w/ patient seated, palpate postero-lateral portion of acromion and mark the skin 1-2 cm below this point;
    - enter the skin at this point;
    - there is no need for the needle to strike acromion;
    - needle should pass easily under acromion;
    - it is then in the subacromial bursa

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Sunday, June 24, 2012 4:32 pm