Clare D J, Wirth M A, Groh G I, Rockwood C A
Department of Orthopaedics, University of Texas Health Science Center at San Antonio, USA.
J Bone Joint Surg Am. 2001 Apr;83(4):593-600. doi: 10.2106/00004623-200104000-00018.
Current indications for shoulder arthrodesis include posttraumatic brachial plexus injuries, paralysis of the deltoid muscle and rotator cuff, chronic infection, failed revision arthroplasty, severe refractory instability, and bone deficiency following resection of a tumor in the proximal aspect of the humerus. The trapezius, levator scapulae, serratus anterior, and rhomboid muscles must be functional to optimize the functional result following shoulder arthrodesis. A consensus has not been reached concerning the ideal position of the shoulder arthrodesis, although excessive abduction or flexion has been associated with chronic postoperative pain. Decortication of both the acromiohumeral and the glenohumeral surfaces to increase the surface area available for arthrodesis is the most common means for obtaining successful fusion. Although there are numerous methods for stabilization of a shoulder arthrodesis, the most popular method today is probably the AO technique with either a single plate or double plates.
目前肩关节融合术的适应证包括创伤后臂丛神经损伤、三角肌和肩袖麻痹、慢性感染、翻修关节成形术失败、严重难治性不稳定以及肱骨近端肿瘤切除后的骨缺损。斜方肌、肩胛提肌、前锯肌和菱形肌必须功能正常，以优化肩关节融合术后的功能结果。尽管外展或屈曲过度与术后慢性疼痛有关，但关于肩关节融合术的理想位置尚未达成共识。对肩峰肱骨关节面和盂肱骨关节面进行去皮质处理以增加可用于融合的表面积是获得成功融合的最常用方法。虽然有许多方法可用于稳定肩关节融合术，但目前最流行的方法可能是使用单钢板或双钢板的AO技术。
