Specialized Toolkit Series: Shoulder Instability-Surgical Technique Spotlight: Open Latarjet

Surgical Technique Spotlight: Open Latarjet – All My Tricks

Video Transcription

Video Summary

This presentation provides a detailed step-by-step walkthrough of the open Bankart procedure with coracoid transfer for shoulder instability. It begins with patient positioning using towels behind the scapula and arm support to optimize access. The deltopectoral approach is described, highlighting key anatomical landmarks like the coracoid, conjoint tendon, coracoacromial ligament, and musculocutaneous nerve. Harvesting the coracoid involves careful cutting and protection of nearby nerves. The coracoid is prepared with a flat surface, predrilled, then fixed onto the glenoid using screws with washers for better compression. Capsular management includes an L-type takedown, subscapularis splitting about two-thirds way, and protective retractor placement for exposure. Various retractor strategies are discussed to optimize visualization. The procedure concludes by attaching and repairing the capsule, with options to incorporate the coracoacromial ligament. The emphasis is on nerve protection, precise anatomical dissection, and secure fixation to promote successful healing and shoulder stability.

Asset Caption

Matthew T. Provencher, M.D., FAANA

Keywords

Open Bankart procedure

Coracoid transfer

Shoulder instability

Deltopectoral approach

Nerve protection