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关节镜下松解上横韧带并对肩胛上神经卡压病例进行SLAP修复固定。

Arthroscopic release of the superior transverse ligament and SLAP refixation in a case of suprascapular nerve entrapment.

作者信息

Hosseini Hamid, Agneskirchner Jens D, Tröger Markus, Lobenhoffer Philipp

机构信息

Department of Trauma and Reconstructive Surgery, Henriettenstiftung, Hannover, Germany.

出版信息

Arthroscopy. 2007 Oct;23(10):1134.e1-4. doi: 10.1016/j.arthro.2006.07.033. Epub 2007 Apr 19.

Abstract

We report a case of suprascapular nerve entrapment at the suprascapular notch combined with a type II SLAP lesion resulting in supraspinatus and infraspinatus muscle weakness and shoulder pain in a 27-year-old female professional handball player. The magnetic resonance imaging scan showed significant atrophy of the supraspinatus and infraspinatus muscles. Electromyography revealed an isolated proximal lesion of the suprascapular nerve. The patient was treated by an arthroscopic release of the superior transverse ligament and repair of the type II SLAP lesion. Follow-up evaluations were performed 6 weeks, 3 months, and 6 months postoperatively. The Constant score improved from 51 to 84 points. Electromyography studies 3 and 6 months after surgery showed significant improvement with normal reinnervation of the supraspinatus and infraspinatus muscles. To our knowledge, this is the first report of proximal suprascapular nerve entrapment with coincidence of a SLAP lesion that was treated arthroscopically. On the basis of this case, we found that arthroscopic release of the superior transverse ligament is an effective procedure for decompression of the suprascapular nerve. Although it is a technically demanding procedure, the arthroscopic approach has the advantage of detecting concomitant lesions such as SLAP lesions.

摘要

我们报告一例27岁职业女子手球运动员,其肩胛上切迹处肩胛上神经卡压合并II型肩盂唇上盂唇从前到后(SLAP)损伤,导致冈上肌和冈下肌无力及肩部疼痛。磁共振成像扫描显示冈上肌和冈下肌明显萎缩。肌电图显示肩胛上神经孤立性近端损伤。患者接受了关节镜下松解上横韧带并修复II型SLAP损伤的治疗。术后6周、3个月和6个月进行了随访评估。Constant评分从51分提高到84分。术后3个月和6个月的肌电图研究显示有显著改善,冈上肌和冈下肌重新获得正常神经支配。据我们所知,这是首例关节镜治疗近端肩胛上神经卡压合并SLAP损伤的报告。基于此病例,我们发现关节镜下松解上横韧带是肩胛上神经减压的有效方法。尽管这是一项技术要求较高的手术,但关节镜手术方法具有能够检测到如SLAP损伤等伴随病变的优势。

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