Safety zone for posterosuperior shoulder access: study on cadavers.

Area of Science:

• Orthopedic Surgery
• Anatomy
• Biomechanics

Background:

• Acromioclavicular (AC) joint dislocation is a common shoulder injury.
• Anatomical reconstruction of coracoclavicular (CC) ligaments is crucial for restoring shoulder stability.
• The posterosuperior shoulder approach offers a potential route for AC joint repair.

Purpose of the Study:

• To determine the safety margins of the posterosuperior shoulder access.
• To measure the distances between the surgical corridor and critical neurovascular structures.
• To provide anatomical guidance for safe surgical technique in AC dislocation treatment.

Main Methods:

• Dissection of 20 adult cadaveric shoulders (10 pairs).
• Utilized a Kirschner wire to simulate the placement of anchors for CC ligament reconstruction.
• Measured distances from the Kirschner wire insertion point to the suprascapular nerve and artery/vein.

Main Results:

• The mean distance to the suprascapular nerve was approximately 18.1 mm (range: 12.6-23.8 mm).
• The mean distance to the suprascapular artery/vein was approximately 13.6 mm (range: 8.8-18.9 mm).
• No significant difference was observed between right and left shoulders.

Conclusions:

• The posterosuperior shoulder access is a viable surgical route for AC dislocation.
• A minimum medial safety margin of 8.83 mm is recommended to protect neurovascular structures.
• This anatomical data aids in optimizing surgical safety and efficacy for CC ligament reconstruction.