文本參考肩肘

1、Complications of Reverse Shoulder ArthroplastyAhmed Kandil,MDConsultant of Orthopedic SurgeryFaculty of MedicineAlexandria UniversityEgyptGood Intentions.Bad esWhat can you control?Patient SelectionSurgical ExposureGlenoid PreparationGlenoid insertionHumeral insertionPostop careDo both youand your p

2、atient.have realisticexpectations?Which stepscan you screw up?Bone qualityNailing a custard pie to the wall- CodmanPostop 2 weeks3 moErrors in guidewireplacementToo highToo lowAngled upwardAngled anteriorAngled posteriorConsequences for:Impingementbaseplate stabilityinstabilitySuperior glenoid erosi

3、onSuperior inclination of baseplateInferior inclination of baseplateBaseplate malpositioningInsufficient reamingPoor contact of baseplateUse medium/large reamerFailure to seat baseplate11 moBaseplate errorsBaseplate too anteriorReaming pleteBASEPLATE SUCCESSExcessive load on shoulder1 month3 mo1 yea

4、r1 mo after revisionUpper compression screwAngle intoBase of coracoidLower compression screwAngle into body Of scapula( 35mm)( 30mm)Screw toolowScrew too short/lowBaseplateInclined upwardBaseplateAlready pulled outRevision on the wayTo failureAvoiding Instability Baseplate low on glenoid proper tens

5、ioning 40mm better than 36mm sizing proper tissue tensioning (tight!) Beware 0,+0 (black) component if greater tuberosity present = impingement0,+0 brings humerusInferiorrisksTuberosity impingement0,+6 avoidsGreater tuberosityimpingmentBlue trial: best for RCTABlack trial: best for revisionIs therapy a good ide