The traditional use of the Trethowan bone lever when providing superior retraction in open shoulder surgeries can result in obstructed views, limited light exposure, and ergonomic strain on assistants. We describe a simple modification of the ring handle spike that addresses these issues, allowing for maximal exposure and improved ergonomics. The curvature of a bent ring handle spike provides superior retraction without obstructing the surgeon's view and keeps the assistant's hand away from the operative field. This modification of the bone lever offers a simple and effective solution to a common problem, enabling adequate visibility to perform shoulder surgery safely and ergonomically.
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