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Type:	Artigo de Periódico
Title:	Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position
Authors:	Mário Chaves Corrêa Érica Antunes Naves Gilvan Ferreira Vaz Thalles Abreu Machado Marco Antônio Percope de Andrade
Abstract:	Background: Shoulder arthroscopy can be performed with the patient in the lateral decubitus or beach-chair position, but in both cases, glenohumeral (GH) joint spaces must be increased to improve visualization and allow access of the optical instrument. The aim of this study was to determine the effects of limb setup and longitudinal traction on the opening of the GH space with patients placed in the beach-chair (dorsal decubitus) position. Methods: GH spaces at 3 test points corresponding to the anatomic locations of Bankart lesions were determined indirectly from radiographic images obtained from 67 patients presenting shoulder pathology with an indication for arthroscopic surgery. Measurements were made with the operative limb in neutral rotation and positioned in relation to the coronal plane in adduction, 45° of abduction, or adduction with an axillary spacer, in each case with and without longitudinal traction. Results: GH spaces were optimized at 2 of 3 test points when the operative limb was positioned in adduction or neutral rotation and manual longitudinal traction was applied with or without a polystyrene spacer placed under the axilla, but use of the spacer was essential to maximize the GH space at all 3 locations. In contrast, 45° of abduction proved to be the least appropriate position because it afforded the smallest GH space values with or without traction. Conclusion: Appropriate positioning of the patient on the operating table is a critical aspect of shoulder arthroscopy. Radiographic images revealed that adducted upper-limb traction with the use of an axillary spacer in patients in the beach-chair position generates a significant increase in the GH space in the lower half of the glenoid cavity, thereby facilitating visualization and access of the optical equipment to the GH compartments.
Subject:	Artroscopia Instabilidade Articular Articulação do Ombro Posicionamento do Paciente
language:	eng
metadata.dc.publisher.country:	Brasil
Publisher:	Universidade Federal de Minas Gerais
Publisher Initials:	UFMG
metadata.dc.publisher.department:	MED - DEPARTAMENTO DE APARELHO LOCOMOTOR
Rights:	Acesso Aberto
metadata.dc.identifier.doi:	10.1016/j.jses.2019.11.003
URI:	http://hdl.handle.net/1843/70169
Issue Date:	2020
metadata.dc.url.externa:	https://pubmed.ncbi.nlm.nih.gov/32195467/
metadata.dc.relation.ispartof:	Journal of Shoulder and Elbow Surgery International
Appears in Collections:	Artigo de Periódico

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