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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781215PMC
http://dx.doi.org/10.4097/kja.19294DOI Listing

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The retroclavicular approach to the infraclavicular region (RAPTIR) is a recently described locoregional technique for upper limb analgesia that offers advantages over the classic infraclavicular block. RAPTIR is considered an effective and easy-to-perform block associated with few complications and better patient comfort. We present a case of a critically ill patient with thoracic and upper limb trauma.

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Background: Regional anesthesia for an upper limb provides many advantages over general anesthesia, especially in orthopedic surgery.

Objectives: This trial aimed to compare a retroclavicular approach to the infraclavicular brachial plexus with a costoclavicular approach in term of needle time, image time, and procedure time, and comparing both with the classic technique for upper limb surgeries guided by ultrasound.

Study Design: Prospective, randomized, single-blinded controlled trial.

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"Champagne Fracture": A Superior Fracture-Dislocation of the Proximal Humerus: A Case Report.

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Department of Orthopaedic Surgery, Upper Limb Surgery Unit, Hospital Lapeyronie, CHU Montpellier, Montpellier, France.

A 79-year-old right-handed woman presented with an indirect trauma to her left shoulder after a fall down the stairs. X-rays and computed tomography showed a four-part glenohumeral fracture-dislocation with a subcutaneous ectopic location of the humeral head in the retroclavicular space. A reverse total shoulder arthroplasty was performed using a deltopectoral approach with direct superior extraction of the humeral head.

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Background: Shoulder dislocations are a common presenting injury to the emergency department (ED), with anterior dislocations comprising the majority of these cases. Some patients may tolerate gentle manipulation and reduction, but many require analgesia of some type. Oral or parenteral pain medication is often used alone or in combination with procedural sedation if gentle manipulation fails to achieve reduction.

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Infraclavicular block provides adequate anesthesia to the arm, forearm, and antecubital region. There are many different approaches to infraclavicular brachial plexus block. Corocoid approach which is mostly preferred is not appropriate in some cases that needle orientation disappear.

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