Harper G D, McIlroy S, Bayley J I, Calvert P T
Royal National Orthopaedic Hospital Trust, London, United Kingdom.
J Shoulder Elbow Surg. 1999 Jan-Feb;8(1):53-7. doi: 10.1016/s1058-2746(99)90056-3.
We describe a new method of arthroscopic bony surgery to the superomedial corner of the scapula in patients with painful snapping caused by bony impingement. Seven patients who had failed conservative treatment were monitored prospectively. In 5 patients we used 3-dimensional computed tomography as a diagnostic aid. The condition was successfully managed in 6 cases. One procedure was abandoned because of intraoperative swelling; there was 1 minor wound infection. In all cases the operation relieved symptoms. Two of the 5 patients scanned had narrowing of the superomedial interval. The advantages of this technique are in cosmesis and early rehabilitation, and the early results are good. Provided due care is taken in portal placement, complications should be minimal. Three-dimensional reconstruction computed tomography scanning may be useful in some patients to show narrowing between the superomedial corner and the chest wall, but we cannot at present recommend its routine use.
我们描述了一种用于治疗因骨撞击导致疼痛性弹响的患者肩胛上内角关节镜下骨手术的新方法。对7例保守治疗失败的患者进行了前瞻性监测。5例患者使用三维计算机断层扫描作为诊断辅助手段。6例患者病情得到成功治疗。1例手术因术中肿胀而放弃；有1例轻微伤口感染。所有病例手术均缓解了症状。扫描的5例患者中有2例肩胛上内角间隙变窄。该技术的优点在于美容效果和早期康复，早期结果良好。只要在入口放置时小心谨慎，并发症应极少。三维重建计算机断层扫描在一些患者中可能有助于显示肩胛上内角与胸壁之间的狭窄，但目前我们不建议常规使用。
