Operative Report Preoperative Explained for Students (Easy Guide)
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OPERATIVE REPORT Preoperative Diagnosis: Severe retracted rotator cuff tear (acute), chronic impingement, acromioclavicular arthritis, right shoulder Post operative Diagnosis: Same Procedure(s) Performed: Anterior acromioplasty and coracoacromial ligament release, acromioclavicular joint debridement with excision of distal tip of clavicle, repair of chronic avulsion and rotator cuff tendon with transosseous sutures The incision was marked along the anterolateral aspect of the shoulder in a longitudinal fashion, and the dissection was carried down through the subcutaneous fat and fascia. The dissection was carried down subperiosteal and anterior to the AC joint and anterolateral acromion. The elongated and beak type III acromion was identified. The anterior acromioplasty was carried out to transform this to a type I acromion. Following this, marked adhesions were noted anteriorly, laterally, and posteriorly. Severe impingement was noted under the undersurface of the AC joint. The AC joint was exposed, and the osteotome was utilized to remove 0.7 cm of the distal clavicle. This allowed marked improvement in the space in the area beneath the distal clavicle. The rotator cuff was severely retracted and was noted to be torn from the area adjacent to the subscapularis, well posteriorly into the teres minor. The tear was carefully advanced, and mattress sutures of 0 Ethibond were utilized X6 for the repair. A trough was made in the area of avulsion, and soft tissue was removed down to bleeding cancellous bone. A margin of cuff was present on the greater tuberosity area, and this was subsequently utilized for interrupted inverted suture repair with 0 Ethibond, following the passage of the transosseous sutures tied along the lateral aspect of the cortex with the arm abducted. Some horizontal portions of the anterior cuff were debrided. There were obvious degenerative changes within the cuff tissue. Partial bursectomy was performed.
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