In Laterjet procedure for managing shoulder instability with glenoid or bipolar bone loss
A 2.5- to 3-cm graft is desirable. This allows us to place 2 screws separated by 1 cm without risks • When cutting the lateral and medial cortex of the graft, be careful not to damage the conjoined tendon. You can start the cut with a saw and finish it with a gouge to have more control • The cortex cut to regularize the graft should be a few millimeters (2 or 3 mm) to avoid jeopardizing the final size of the graft. If the graft is too small, it can be fractured when placing the screws
• Proper positioning of the coracoid graft relative to the glenoid is critical: the pegs on the parallel drill guide allow for easy positioning of the coracoid graft onto the glenoid
• The optimal position is between the 3- and 5-o’clock position flush with the articular surface. Excessive medialization of the coracoid graft may fail to improve glenohumeral stability, whereas excessive lateralization of the coracoid graft can result in an increased rate of postoperative degenerative changes about the glenohumeral joint
