Shoulder & Elbow Surgical Exposure Workshop

The Master of Orthopaedic Surgery (MCh Orth) candidates attended a Shoulder & Elbow Surgical Exposure Workshop organised and jointly run by Mr Aprit Jariwala (Consultant Upper Limb and Trauma Surgeon & Honorary Clinical Reader) on the morning of November 22, 2018.

The workshop was held at the Centre for Anatomy & Human Identification (CAHID) at the main University Campus where the participants undertook the various surgical approaches themselves. Pairs of participants had a Thiel cadaver to themselves and for every participant there was a faculty member leading them through the various exercises.

Thiel embalmed cadavers were used, which is unique to the MCh (Orth) Dundee course, and affords more realistic, moveable and flexible cadavers to simulate real-life surgery. All students will receive a certificate of participation.

The first session of the workshop concentrated on Deltopectoral approach:

1. Surface marking of incision
2. Identification of cephalic vein and DP interval
3. Biceps tenotomy and pec majr identification
4. Subscapularis tenotomy
5. Exposure of glenohumeral joint
6. Extending the DP approach to the elbow and visualisation of the radial nerve

The second session centred on the Mackenzie approach:

1. Surface marking of the incision
2. Deltoid split and subacromial space exposure
3. Identification of cuff
4. Exposure of ‘footprint’ for cuff repair
5. Identification of axillary nerve
6. Extending the approach to the elbow and visualisation of the radial nerve

The last session of the workshop focussed on the posterior approach to the elbow joint:

1. Ulnar nerve exposure
2. Decompression and transposition
3. The tricky ‘’posterior approach to the shoulder joint.

After the workshop, Professor Rami Abboud (MCh Orth Course Director) presented Mr Pete Rickhuss with a set of MCh (Orth) etched whisky glasses to mark his retirement earlier this year, and to thank him for all his support over the last 18 years.

Left: Staff and students at CAHID; Right: Professor Abboud presenting Mr Rikhuss with a gift to mark his retirement

Mr Arpit Jariwala stated:

“I would personally like to thank my colleagues and fellow Faculty members, Mr Pete Rickhuss, Mr Simon Thomas and Mr Douglas Robinson for their expertise and assistance in giving their time freely to demonstrate surgical techniques to this year’s participating students. I hope the students learned something new that they can employ in their own orthopaedic practice.”

Professor Rami Abboud, Head of Department of Orthopaedic & Trauma Surgery added:

“On behalf of the MCh (Orth) candidates and myself, as MCh (Orth) Course Director, I would like to say a great big thank-you to Mr Jariwala (himself a MCh Orth, Dundee, Graduate from 2003) and the attending Faculty on the outstanding organisation of this annual workshop. It is a fantastic opportunity for our candidates to benefit from the sharing of their vast orthopaedic surgery skills. The Thiel embalmed cadavers gives our MCh (orth) candidates the rare opportunity to experience this unique approach in regard to surgical training techniques”.

Dr Abhimanyu Kumar, a current MCh (Orth) candidate and participant of the workshop stated:

“Dear Mr Jariwala. I thank and congratulate you and your team for conducting the Cadaveric Workshop for upper limb exposures, which was highly educational and well appreciated by us MCh Students. I thank the external, as well as, the internal faculties for taking part. Interaction with them and learning about different ways of managing pathologies are surely going to help us in our practice. It has been a great learning experience till now. We are looking forward to further workshops, and waiting eagerly for work shop on Lower Limb Exposures & Approaches, and Exposures for Spine”.

Dr Mohammad Abubakr Riaz, a current MCh (Orth) candidate and participant of the workshop added:

“Dear Mr Jariwala. I would wholeheartedly like to thank you and the department for an excellent teaching session at the anatomy and the human identification centre. The cadavers were amazing but the guidance and tips you and your colleagues imparted were outstanding. I think this was the best day I have had so far on the MCh (Orth) course. I greatly appreciate that our department went out of their way to arrange a whole upper limb demonstration exploring the whole upper limb compared to a more focused shoulder demo as in the past. I hope that we will get a similar opportunity in Semester Two for the lower limb. The mini symposium on shoulder instability was also very enlightening. I feel greatly indebted to you, Professor Abboud and the honourable guest lecturers”.

Please note that due to our strict adherence to Thiel copyright and legal agreement we are obviously restricted as to what imagery we can show in the public domain. We would like to take this opportunity to thank all those who generously bequeath their bodies to medical science for anatomical examination, research, and education and training. Without these generous individuals, research and future surgical understanding continues to advance.