S3™ Proximal Humerus Plating System Surgical Technique - Biomet
S3™ Proximal Humerus Plating System Surgical Technique - Biomet
S3™ Proximal Humerus Plating System Surgical Technique - Biomet
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<strong>Surgical</strong> <strong>Technique</strong><br />
<strong>Surgical</strong> <strong>Technique</strong><br />
Step 1: Procedure Mapping<br />
• Exposure: deltopectoral<br />
• Identify: coracoid, acromium and<br />
deltoid insertion<br />
Step 4: Exposure<br />
• The exposure is through a 12 ‐ 14 cm incision<br />
• Identify and retract the cephalic vein<br />
• Develop the interval between the pectoralis<br />
and deltoid<br />
• Extend incision line distal from coracoid<br />
• Self retaining retractors are useful for exposure<br />
Tips: during the exposure, the 2.8 mm drill<br />
bit can be loaded in preparation for plate<br />
application.<br />
Step 2: Patient Positioning<br />
• Sterile Mayo stand assists during dissection<br />
Tips: the procedure can be performed in the<br />
beach chair position or supine as per surgeon’s<br />
discretion.<br />
Step 5: Pectoralis Incision and<br />
Identification of the Biceps Tendon<br />
• Gently retract the coracobrachialis medially<br />
• Find the pectoralis insertion at the floor of the<br />
deltoid pectoralis interval<br />
• Release the proximal third of the pectoralis<br />
tendon to expose the biceps<br />
Step 3: Acquire Initial Images<br />
• Examine the fracture under fluoroscopy<br />
• Internal rotation, external rotation and<br />
sometimes axillary views are necessary<br />
Step 6: Complete Exposure<br />
• Develop the subacromial space and mobilise<br />
the proximal deltoid<br />
Tips: use of a large, blunt humeral head<br />
depressor can facilitate exposure.<br />
4 5
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