Coracoid process fractures
Scapular process fractures
Types
Coracoid process
Scapula spine
Acromial fractures
Coracoid process
Scapula spine
Acromial fractures
Osteoarthritis
- abnormal morphology
- loss of head neck offset
- bony impingement on acetabulum
AVN
- 85 intra-articular ganglions
- 49 ACL, 16 PCL
- 12 from anterior horn meniscus, 3 posterior horn meniscus
- 3 from fat pad
Technique
Surgical technique PDF using trans-septal portal
Deformity correction
Poor soft tissues
- prohibit ORIF
Non union
Infected non uniion
Malunion / deformity
Bone loss / bone transport / LLD
Indication
Bony defects > 30 %
Options
- Latarjet - may be insufficient for lesions in the region of 50%
- Iliac crest - associated with high incidence of OA
- distal tibial allograft - radius of curvature matches glenoid highly
Engaging Hill Sachs
Platelet rich plasma
2 main components
1. Platelets
- contain PDGF, TGF, VEGF
2. Growth factors
- ILGF
- FGF
Formed from the separation of whole blood into plasma and RBC
- separation usually achieved with centrifugation
Platelet concentration