Which joint position puts the axillary nerve at lowest risk when performing arthroscopic capsular release in patients with adhesive capsulitis of the shoulder?

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
J JeroschE T Peuker

Abstract

The success of arthroscopic capsular release of the glenohumeral joint depends on complete incision of the inferior capsule. This study determined the distance between capsule and the axillary nerve in different joint positions. In 14 human shoulder specimens the anterior joint capsule and axillary nerve were dissected, and the anterior joint capsule was incised between the 1 and 5 o'clock positions. The shortest distance between the insertion of the inferior capsule and the axillary nerve was measured at the glenoid and humeral insertions in abduction, adduction, internal, and external rotation. The axillary nerve is surrounded from soft connective tissue and is closer to the humeral than to the glenoidal attachment of the joint capsule. During abduction and external rotation the nerve stays in its position while the glenohumeral capsule tightens, which increases the distance between the two structures. This results in the following distances: to the glenoidal/humeral capsule insertion: in adduction and neutral rotation, 21.2+/-4.2/14.2+/-2.6 mm; in abduction and neutral rotation, 24.0+/-4.9/15.0+/-5.0 mm; in abduction and internal rotation, 21.1+/-6.6/14.6+/-3.7 mm; and in abduction and external rotation, 24.9+/-3.8/16.4+/-4....Continue Reading

Citations

Jul 6, 2012·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Joerg JeroschAli M Reda Mansour
Mar 15, 2011·Journal of Shoulder and Elbow Surgery·Robert A Magnussen, Dean C Taylor
Aug 28, 2010·Journal of Shoulder and Elbow Surgery·Carla SteccoRoberto Aldegheri
Apr 7, 2010·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Jiwu ChenHongyun Li
Dec 29, 2015·Cirugia y cirujanos·Jorge Gutiérrez-de la OSantos Guzmán-López
Dec 8, 2007·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Jae Chul YooSeok Hyun Lee
Aug 2, 2005·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Pablo Eduardo GelberEnrique Caceres
Dec 10, 2013·Orthopaedics & Traumatology, Surgery & Research : OTSR·A LädermannJ H D Fasel
Jun 15, 2016·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Adrián CuéllarMiguel Angel Ruiz-Ibán
Jul 4, 2017·JBJS Reviews·Justin J MitchellJonathan T Bravman
Apr 30, 2017·Journal of Back and Musculoskeletal Rehabilitation·Kyung-Hee KimKi Young Oh
Feb 15, 2017·Revista Brasileira De Ortopedia·Alberto Naoki MiyazakiSergio Luiz Checchia
Mar 14, 2020·Orthopaedic Journal of Sports Medicine·Tim KraalMichel P J van den Bekerom
Jan 23, 2013·JBJS Essential Surgical Techniques·Lijkele Beimers, George A C Murrell

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