title: Safety zone for posterosuperior shoulder access: study on cadavers.
abstract: OBJECTIVE
  The posterosuperior shoulder access used in surgical treatment for acromioclavicular dislocation was constructed through dissection of 20 shoulders from 10 recently chilled adult cadavers, and the distances from this route to the nearby neurovascular structures were analyzed.
  
  
  METHODS
  A Kirschner wire was introduced into the top of the base of the coracoid process through the posterosuperior shoulder access, in the area of the origin of the conoid and trapezoid ligaments, thus reproducing the path for inserting two anchors for anatomical reconstruction of the coracoclavicular ligaments. The smallest distance from the insertion point of the Kirschner wire to the suprascapular nerve and artery/vein was measured.
  
  
  RESULTS
  The mean distance from the suprascapular nerve to the origin of the coracoclavicular ligaments at the top of the base of the coracoid process was 18.10 mm (range: 13.77-22.80) in the right shoulder and 18.19 mm (range: 12.59-23.75) in the left shoulder. The mean distance from the suprascapular artery/vein to the origin of the coracoclavicular ligaments was 13.10 mm (range: 9.28-15.44) in the right shoulder and 14.11 mm (range: 8.83-18.89) in the left shoulder. Comparison between the contralateral sides did not show any statistical difference.
  
  
  CONCLUSIONS
  The posterosuperior shoulder access route for anatomical reconstruction of the coracoclavicular ligaments in treating acromioclavicular dislocation should be performed respecting the minimum limit of 8.83 mm medially.
authors: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors: Miguel Pereira
authors: MP
authors: Costa
authors: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors: Sandro Baraldi
authors: SB
authors: Moreira
authors: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors: Gustavo Costalonga
authors: GC
authors: Drumond
authors: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors: Fernanda de Marchi Bosi
authors: Fde M
authors: Porto
authors: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors: Fabiano Rebouças
authors: FR
authors: Ribeiro
authors: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors: Antonio Carlos
authors: AC
authors: Tenor
keywords: Acromioclavicular joint/surgery; Operative surgical procedures; Shoulder/anatomy and histology; Shoulder/innervation