Taylor Spatial Frame
Indications
Deformity correction
Deformity correction
Poor soft tissues
- prohibit ORIF
Non union
Infected non uniion
Malunion / deformity
Bone loss / bone transport / LLD
https://www.vumedi.com/video/arthroscopic-double-row-subscapularis-repa…
Technique
- extra-articular
Portals
- posterior portal very lateral so can see anterior aspect subacromial space
- port of Wilminton at anterolateral acromion to access SSC
- anterior portal in normal position, slightly more lateral so becomes working portal
Engaging Hill Sachs
Platelet rich plasma
2 main components
1. Platelets
- contain PDGF, TGF, VEGF
2. Growth factors
- ILGF
- FGF
Formed from the separation of whole blood into plasma and RBC
- separation usually achieved with centrifugation
Platelet concentration
Types
1. Supracondylar
2. Unicondylar
3. Intracondylar
Supracondylar / Extra-condylar
1. Provide representative sample
- to determine whether benign or malignant
- to determine cell line
- to grade lesion
2. Not compromise definitive treatment
Last step in evaluation / after staging
Don't perform definitive procedure immediately after biopsy unless
- pre-operative & Xray information characteristic
Place the patient in the supine position
- small roll placed under the shoulder blades to drop the shoulders from the field
- exposes the anterior neck
- strap the shoulders at the side with minimal traction
Option 1
- lateral and medial aspect femoral trochlea
Option 2
- intercondylar notch
Option 3
- allograft
- can take larger grafts without donor site risk
- head that translates 50% in all directions
- allows 30o ER with arm at side
- stable posteriorly
- antibiotics
- consider specific Propionobacterium cover