Rothberg David L, Burks Robert T
University Orthopaedic Center, University of Utah Health Science Center, Salt Lake City, UT84102, USA.
Arthroscopy. 2009 Aug;25(8):934-6. doi: 10.1016/j.arthro.2008.09.019. Epub 2008 Nov 22.
Anterior glenohumeral instability typically involves lesions associated with the inferior glenohumeral ligament complex. Multiple lesions have been described in this setting, including Bankart, humeral avulsion of the inferior glenohumeral ligament complex, and mid-substance capsular tears. These lesions are indicative of the high-force traumatic nature of anterior shoulder dislocation. Two cases of recurrent anterior shoulder instability are presented with a capsular tear perpendicular to the usual orientation and not consistent to the amount of force involved in a dislocation. Arthroscopy revealed a capsular defect from the glenoid to the humeral head in the anterior inferior glenohumeral ligamentous complex in both. This lesion is an unusual circumstance, providing another pathology to include in the differential diagnosis of anterior glenohumeral instability.
肩关节前向不稳通常涉及与肩胛下盂肱韧带复合体相关的损伤。在这种情况下已描述了多种损伤,包括Bankart损伤、肩胛下盂肱韧带复合体的肱骨撕脱伤以及关节囊中部撕裂。这些损伤表明前肩关节脱位具有高暴力创伤的性质。本文报告2例复发性前肩关节不稳病例,其关节囊撕裂方向与通常方向垂直,且与脱位所涉及的力量大小不一致。关节镜检查发现两例患者的前下肩胛下盂肱韧带复合体均存在从关节盂到肱骨头的关节囊缺损。这种损伤情况不常见,为肩关节前向不稳的鉴别诊断增加了另一种病理情况。