The superior or saber cut approach is a straight incision running directly from front to back.
It is used to expose the AC-joint and the acromion.
2. Skin incision
Anatomical landmarks for the superior approach are:
A) AC joint B) The dorsal rim of the acromion
Both landmarks can easily be palpated.
Begin anteriorly over the humeral head, carry the incision over the AC joint and end at the posterior aspect of the acromion. If necessary the incision can be extended to join the deltopectoral approach anteriorly. Dorsally this approach can be extended to join a standard posterior approach.
To expose the fracture line of the acromion. A partial detachment of the deltoid muscle and trapezius may be necessary.
Reattach the released muscles; close in layers, closing the fascia, and subcutaneous plane, and then the skin.