Barwood Shane A, Burkhart Stephen S, Lo Ian K Y
Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
Arthroscopy. 2007 Feb;23(2):221-5. doi: 10.1016/j.arthro.2006.11.011.
Arthroscopic release of the suprascapular nerve at the suprascapular notch, to our knowledge, has rarely been described. The purpose of this study was to evaluate the feasibility and relevant anatomic landmarks in a cadaveric model that can be identified arthroscopically for reliable and reproducible arthroscopic release of the superior transverse scapular (STS) ligament. In 8 fresh-frozen cadaveric shoulders, arthroscopic release of the STS ligament was performed. The acromioclavicular joint is first identified while viewing through a posterior subacromial portal. The distal clavicle is then followed medially until the most lateral portion of the coracoclavicular (CC) ligaments (trapezoid ligament) is identified. The most medial margin of the CC ligaments (conoid ligament) is identified, and the trapezoid and conoid ligaments are dissected and identified individually. The conoid ligament is followed inferiorly and medially to the base of the coracoid. At the base of the coracoid, the confluence of the trapezoid and conoid ligaments (CC) and the STS ligament is identified. The STS ligament can be identified coursing horizontally across the field of view. The STS ligament may be incised by use of dissecting scissors through a lateral, accessory lateral, or accessory posterior portal, releasing the suprascapular nerve.
据我们所知，关节镜下在肩胛上切迹处松解肩胛上神经的情况鲜有报道。本研究的目的是在尸体模型中评估关节镜下可识别的用于可靠且可重复地松解肩胛上横韧带（STS）的可行性及相关解剖标志。对8具新鲜冷冻尸体肩部进行了关节镜下STS韧带松解。首先通过肩峰下后入路观察来识别肩锁关节。然后沿锁骨向内侧追踪，直至识别出喙锁韧带（梯形韧带）的最外侧部分。识别出喙锁韧带（圆锥韧带）的最内侧边缘，并分别解剖和识别梯形韧带和圆锥韧带。沿圆锥韧带向下方和内侧追踪至喙突基部。在喙突基部，识别出梯形韧带和圆锥韧带（喙锁韧带）与STS韧带的汇合处。可以看到STS韧带在视野中呈水平走行。可通过外侧、辅助外侧或辅助后入路使用解剖剪切开STS韧带，松解肩胛上神经。
