Name:
Modified Weaver-Dunn Procedure for Chronic ACJ Dislocation
Description:
Modified Weaver-Dunn Procedure for Chronic ACJ Dislocation
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/33fce0a0-0de8-4182-b7b0-46a8da038181/videoscrubberimages/Scrubber_1.jpg
Duration:
T00H05M00S
Embed URL:
https://stream.cadmore.media/player/33fce0a0-0de8-4182-b7b0-46a8da038181
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/33fce0a0-0de8-4182-b7b0-46a8da038181/Modified Weaver-Dunn Procedure for Chronic ACJ Dislocation.mp4?sv=2019-02-02&sr=c&sig=n0jihyKL%2FuRJsIRnDoHqhL0AqaFiHuhxz8cM3M%2Fs1GM%3D&st=2024-11-23T08%3A31%3A39Z&se=2024-11-23T10%3A36%3A39Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Hello, with us today, I'm going to take you through a surgical procedure for a chronic economic ocular joint dislocation. Now, the procedure that we are going to do today is called modified Weaver-Dunn procedure. I have already uploaded a few videos about ACG reconstruction, and if you're visiting my channel for the first time, I would request you to subscribe to the channel as you will find many useful videos which will be extremely useful in clinical practice.
So today my goal is to take you through step by step as how to perform a modified Weaver-Dunn procedure for a chronic extra-clavicle joint dislocation. So a patient today is a 38-year-old gentleman who fell on his shoulder around 4 and 1/2 months ago and did not seek any medical advice. Now presented to us with pain in his left shoulder and a prominent lump on top of his shoulder.
And if you see this x ray, you can see that the coracoclavicular extensor is increased. There is discongruity of external claviclular joint, and there is a complete subluxation. It looks like at least type three kind of injury. And also you can see associated degenerative changes. So today our plan is to do a modified Weaver-Dunn procedure in order to take his pain away and correct his deformity. So this is our theatre position.
We do this in beta position. Of course you need to have a shoulder table or you have to reverse the table to get this into this position. You get your anaesthetist to put the tube and then turn the head on the opposite side so that you have got good access right from the sternal lodge onto the lateral end of the clavicle. Now my trolley is going to be on my left hand side and my screen, CR screen will be right in the front so that I have got access all the time and this is my CR.
Now, I'm not going to tell you how to position the CR in case you want to fix as ex-coracoclavicular joint. Because I've already uploaded a video. I would advise you to see that we do. That will beautifully explain what should be the position of CR and how should you position the CR to get a perfect, perfect circle of coracoid.
So I'll skip that and we'll move on to the skin incision. So one thing I would recommend if you're doing any surgery is start using this marking pen. Marking a skin incision is a very good practice and you're not going to lose anything by marking. So I always mark it so this is your land mark. So this is the lateral end of the clavicle. You can see this bulge very clearly seen. This is the roughly the acromion.
This is the coracoid which I felt here. Now you can make your incision like a bra strap, as shown in my other video in which I fixed an acute dislocation. This is chronic, so I'm going to use a horizontal incision which will be just inferior to the clavicle. Now this is your clavicle. You center this incision onto the coracoid so that you have got access medially as well as laterally. Now, before you do any surgeries in any across shoulder joint, always use local anesthetic with some adrenaline and this will help you to reduce your bleeding because it is quite a vascular area.
So whenever you're dissecting skin or platysma, this decreases the risk of bleeding so it comes as a pretty mixed formula. So I will definitely advise you to start using it in areas where you cannot use the tourniquet. So I'll just wait for a few minutes and then we'll start our skin incision. So we just waited a few minutes. I'll try my best so that my hand is not coming in front of the camera because then Prakesh won't be happy.
So I'm just going to make my skin incision. So straightforward, you don't have much important structures here, so just take the skin incision, take the skin down, and keep dissecting in a layered fashion. So I'm just cut the skin. I'm just going to take, put some self retaining retractors. Do some hemostasis and then I will join you.
So, so far we have just taken the skin and subcutaneous tissue down. You don't see much fat here, especially in thin patient. Now, I'm not a great fan of cautery, and if you have seen my videos in the past, you will see I rarely use the cautery, but on this occasion this is one time I would recommend you to use cautery. So this is my clavicle. You can see it if.
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