Cadaveric dissection study of 102 embalmed and 10 fresh shoulders measuring the precise distance of the axillary nerve's anterior division from four standard acromial surgical landmarks, and quantifying how passive shoulder abduction alters that distance. Directly challenges the textbook teaching that 5 cm from the acromion is a safe limit for deltoid splitting.
When performing any deltoid-splitting approach — whether for acromioplasty, mini-open cuff repair, or posterior exposure — keep splitting to ≤3 cm from the acromion in all patients and ≤2.5 cm in women or small-framed individuals; if the arm is abducted intraoperatively, treat that margin as even tighter and place a stay suture at the distal extent of the split.
Cadaveric dissection study of 102 embalmed and 10 fresh shoulders measuring the precise distance of the axillary nerve's anterior division from four standard acromial surgical landmarks, and quantifying how passive shoulder abduction alters that distance. Directly challenges the textbook teaching that 5 cm from the acromion is a safe limit for deltoid splitting.
When performing any deltoid-splitting approach — whether for acromioplasty, mini-open cuff repair, or posterior exposure — keep splitting to ≤3 cm from the acromion in all patients and ≤2.5 cm in women or small-framed individuals; if the arm is abducted intraoperatively, treat that margin as even tighter and place a stay suture at the distal extent of the split.