Deltopectoral Approach to the Shoulder # 3D Animation /// #Anatomy

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Deltopectoral Approach to the Shoulder in 3D | #Step-by-Step Surgical Anatomy.

Indications://

Shoulder Approach Indications:
Proximal humerus fracture fixation
Long head of biceps injury
Recurrent shoulder dislocation
Shoulder arthroplasty
Sepsis drainage
Tumor surgery
Anterior rotator cuff procedures

Deltopectoral (Anterior) Approach – Stepwise Summary

1. Positioning:

Patient is in supine or beach-chair position.
The arm is draped freely to allow manipulation.

2. Skin Incision:

Make an incision from just below the clavicle (coracoid process) down towards the deltoid insertion along the deltopectoral groove.

3. Superficial Dissection:

Incise through subcutaneous tissue.
Identify and protect the cephalic vein (important!):
Retract laterally with the deltoid (common) or medially with the pectoralis major.

4. Deltopectoral Interval:

Separate the deltoid (laterally) and pectoralis major (medially).
Blunt dissection may help identify the plane.

5. Clavipectoral Fascia:

Incise the clavipectoral fascia to expose the subscapularis.

6. Access to Joint:

Identify and retract conjoint tendon medially.
Expose and incise the subscapularis tendon (either peel, tenotomy, or osteotomy) to access the joint capsule.
Open the joint capsule to access the glenohumeral joint.

7. Procedure-Specific Steps:

Perform the intended procedure (e.g., fixation, replacement, biopsy, etc.).

8. Closure:

Repair the subscapularis.
Reapproximate the deltopectoral interval.
Close subcutaneous tissue and skin in layers.
Possible complications

Well known risks of this approach include
Injury to the
1 cephalic vein
2 musculocutaneous nerve
3 Axillary nerve
Notic////

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