DONUTS and hot dogs have extended their appeal beyond casual cafeteria conversation, up the small talk of elevator journeys, down the discourse of hallowed hallways and into the very inner sanctum of operating room theaters.

The substance of sustenance is not food, of course, but the new blade attachments adorning Buxton's series of shoulder retractor frames and the colloquialisms used to describe them. This palatable pair finds enthusiastic converts amongst shoulder surgeons struggling to access those massive rotator cuff tears inconveniently tucked between the underside of the acromion and humeral head. Effectively performing this tricky repair requires instruments able to bring the necessary applied force to the right locations using the optimal interface.

Reaction to Distraction
Distractors specifically designed to gain access to the subacromial space are not new, but other versions are typically over-engineered, over-wrought and often difficult to obtain. These distractors can be so large and ungainly that their leveraged weight alone may easily crack the acromion. Buxton's approach resulted in a system that is simple, flexible, versatile and (most importantly) economical.

The "Berliner" ring blade with its smooth surface 25 mm diameter hoop, sits like a crown on the humeral head. The opposite "Frankfurter" lever blade measures 50 x 9 mm and boasts crosshatch serration on the side intended to grip the inferior surface of the acromion. Ball-snap hubs adorn each of these blades so that they fit any one of the family of shoulder frames offered by Buxton. However, the flexible arms coupled with the one-handed operation of the Mini-Open retractor, makes it the frame of choice for the Buxton Distractor (24-6331).

Angled arms are very desirable in a distractor as they keep the body of the device out of the line of vision, but because the tips are dissimilar, angling the shafts often creates the need for right and left versions. Buxton's distractor works on either side thanks to arms that articulate fore and aft from the straight through an arc of 180°. Moreover, its blades pop out and switch around to convert a left shoulder distractor into a right shoulder distractor in seconds!

More Distraction Action: Retraction
Remember, the frame of the distractor is also a component of the shoulder retractor. With the additional purchase of the Kölbel narrow, mini-cuff blades, this device will not only distract, but also retract, which will certainly attract those surgeons looking to have their donuts and eat them too.

Humerus Areas, Vol. 2, No. 2