Medical Malpractice Insurance for orthopaedic surgeons

Triangular Space of Shoulder

– See:       – see quadrangular space  – Formed by Borders of:      -Teres Major      -Teres Minor      – Long Head of triceps – scapular circumflex artery travels posteriorly thru trinagular space


                        – Discussion:     – trapezius and serratius anterior  stabilize scapular base from which the arm operates;     – trapezius, which arises from spinous processes of  cervical and thoracic vertebrae  & inserts on spine of scapula            and acromion, is innervated by spinal accessory nerve and branches from third … Read more

Transection of the Subscapularis

– Evaluation of Muscle:     – about 5% of shoulders that have had an anterior dislocation will sustain a irrepairable injury to the subscapularis, which will contribute to             further instability;            – in this case, a pectoralis transfer would be indicated; – Preparation:     – identify the anterior humeral circumflex … Read more

Transaxial View of the Shoulder

– Discussion:     – used to evaluate capsule of shoulder, & glenoid labrum, subscapularis  & long head of the biceps, and the humeral head;     – glenoid labrum produces low signal intensity since it is made of fibrous tissue;     – Hill-Sachs lesion, seen as a notched defect of flattening of humeral … Read more

Total Shoulder Arthroplasty: Glenoid Component

– Discussion:     – operative considerations: hemiarthroplasty vs total shoulder arthroplasty     – anatomy:           – normal population, glenoid version: from 5 deg of anteversion to 15° of retroversion, with an                     avg preop retroversion range from 1 deg to 6 deg;            – surgical goal of resurfacing is to place the glenoid in 0° … Read more

Shoulder Arthroplasty – Mobilization and Repair of Subscapularis

– Discussion:        – subscapularis anatomy: mobilization (360 deg release):        – mobility of the subscapularis can be limited by adhesions to conjoined muscles, coracoid, glenoid, and capsule;        – releases are required order to liberate subscapularis circumferentially about its long axis;         – muscle should be fully mobilized off of the anterior glenoid;        – … Read more

Total Shoulder Replacement vs Hemiarthroplasty

– Operative Considerations: hemiarthroplasty vs total shoulder arthroplasty:      – preoperative planning must take the following in consideration: status of rotator cuff, bone stock, asymmetric wear, and type and                extent of soft tissue contractures;      – expectations:             – patients should not generally expect to achieve elevation … Read more

Teres Minor

  – See Rotator cuff: – anatomy:     – origin: middle half of the lateral scapular border;     – insertion: inferior aspect of greater tuberosity of the humerus, capsule of shoulder joint; – action:     – lateral rotation of humerus at the shoulder (responsible for 45% of power of external rotation);   … Read more