Neer Charles S
J Bone Joint Surg Am. 2005 Jun;87(6):1399. doi: 10.2106/JBJS.8706.cl.
Impingement on the tendinous portion of the rotator cuff by the coracoacromial ligament and the anterior third of the acromion is responsible for a characteristic syndrome of disability of the shoulder. A characteristic proliferative spur and ridge has been noted on the anterior lip and undersurface of the anterior process of the acromion and this area may also show erosion and eburnation. The treatment of the impingement is to remove the anterior edge and undersurface of the anterior part of the acromion with the attached coracoacromial ligament. The impingement may also involve the tendon of the long head of the biceps and if it does, it is best to decompress the tendon and remove any osteophytes which may be in its groove, but to avoid transplanting the biceps tendon if possible. Hypertrophic lipping at the acromio-clavicular joint may impinge on the supraspinatus tendon when the arm is in abduction and, if the lip is prominent, this joint should be resected. These are the principles of anterior acromioplasty.
喙肩韧带和肩峰前三分之一对肩袖肌腱部分的撞击是导致肩部典型功能障碍综合征的原因。在肩峰前突的前缘和下表面已发现特征性的增生性骨刺和嵴，该区域也可能出现侵蚀和骨质象牙化。撞击的治疗方法是切除肩峰前部的前缘和下表面以及附着的喙肩韧带。撞击也可能累及肱二头肌长头肌腱，如果是这样，最好对该肌腱进行减压并去除其沟内可能存在的任何骨赘，但尽可能避免移植肱二头肌肌腱。当手臂外展时，肩锁关节的肥厚唇样增生可能会撞击冈上肌腱，如果唇样增生明显，应切除该关节。这些就是前肩峰成形术的原则。
