Article

Shoulder endoscopy is evolving and becoming extra-articular. More and more
procedures are taking place in the area of the brachial plexus (BP). We carried
out an anatomical study to describe the endoscopic anatomy of the BP and the
technique used to dissect and expose the BP endoscopically. Thirteen fresh
cadavers were dissected. We first performed an endoscopic dissection of the BP,
using classical extra-articular shoulder arthroscopy portals. Through each
portal, we dissected as many structures as possible and identified them. We then
did an open dissection to corroborate the endoscopic findings and to look for
damage to the neighboring structures. In the supraclavicular area, we were able
to expose the C5, C6 and C7 roots, and the superior and middle trunks in 11 of 13
specimens through two transtrapezial portals by following the suprascapular
nerve. The entire infraclavicular portion of the BP (except the medial cord and
its branches) was exposed in 11 of 13 specimens. The approach to the
infraclavicular portion of the BP led directly to the lateral and posterior
cords, but the axillary artery hid the medial cord. The musculocutaneous nerve
was the first nerve encountered when dissecting medially from the anterior aspect
of the coracoid process. The axillary nerve was the first nerve encountered when
following the anterior border of the subscapularis medially from the posterior
aspect of the coracoid process. Knowledge of the endoscopic anatomy of the BP is
mandatory to expose and protect this structure while performing advanced arthroscopic shoulder procedures.
CI - Copyright (c) 2015 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS