Hill J David, Lovejoy John F, Kelly Robert A
Department of Orthopaedic Surgery, Atlanta Medical Center, Atlanta, Georgia, USA.
Arthroscopy. 2007 Mar;23(3):327.e1-3. doi: 10.1016/j.arthro.2005.09.026. Epub 2006 Sep 11.
Recurrent posterior glenohumeral instability is uncommon and is often misdiagnosed. Damage to the posterior capsule, posteroinferior glenohumeral ligament, and posterior labrum have all been implicated as sources of traumatic posterior instability. We describe a case of traumatic recurrent posterior instability resulting from a posterior Bankart lesion accompanied by posterior humeral avulsion of the glenohumeral ligaments. The Bankart lesion was repaired using a single arthroscopic suture anchor at the glenoid articular margin. The posterior humeral avulsion of the glenohumeral ligaments was addressed with 3 suture anchors placed at the capsular origin at the posterior humeral head. Using these anchors, the posterior capsule was advanced laterally and superiorly for a secure repair. Arthroscopic anatomic reconstruction of both lesions resulted in an excellent clinical outcome.
复发性肩肱关节后向不稳并不常见,且常被误诊。后关节囊、肩肱关节后下韧带和后盂唇损伤均被认为是创伤性后向不稳的病因。我们描述了一例因后孟氏损伤伴肩肱韧带肱骨后脱位导致的创伤性复发性后向不稳病例。通过在关节盂关节边缘使用单个关节镜缝合锚钉修复孟氏损伤。使用3个缝合锚钉固定于肱骨头后方的关节囊起点,修复肩肱韧带肱骨后脱位。通过这些锚钉,将后关节囊向外上方推进以进行牢固修复。对这两种损伤进行关节镜下解剖重建,临床效果极佳。