Key Terms: Primogenitor, Natural Selection, Survival of the Fittest.

Long popular as the humeral head retractor of choice, the Fukuda retractor remains a mainstay of so many shoulder sets. Once seated in the glenohumeral joint, the ring opening at the distal end of the flat, broad blade encircles the humeral head, allowing lateral retraction of the humerus and exposure of the glenoid rim along with its articular surface.

The original retractor featured a thin, broad strip of steel, 140 mm long by 25 mm wide with a 45° inferior bend 90 mm from the distal end. The single bend helped place the assistant's hand out of the surgeon's line of view, but it still presented a rather high profile when the instrument was fully inserted and in place.

The Kujat variant offered by Buxton spreads that angle out by placing a 30° bend proximal to the handle, and another 15° bend two thirds of the way down the remaining blade. A 25 mm extension to the "T" handle is further testament to the importance placed on keeping the hands of over zealous coadjutors safely out of the critical field. The Kujat also "sports" a 15° forward reaching contra-bend only 20 mm from its distal most end. This convenient lip allows the retractor to lever against the bone of the posterior glenoid neck and reduces the chance of inadvertently fracturing the fragile posterior glenoid rim. Light serrations have been strategically placed around the ring to improve traction.

The Shoulder, Vol. 1, No. 3