Chandler Justin W, Williams Gerald R
Department of Orthopaedic Surgery, Rothman Institute at Jefferson, Philadelphia, PA, USA.
Instr Course Lect. 2011;60:91-7.
In patients treated with total shoulder arthroplasty, it is beneficial to be aware of several tips and tricks to optimize patient outcomes. Prior to surgery, appropriate preoperative planning is essential to ensure a smooth procedure with no unexpected intraoperative findings. The procedure begins with appropriate patient positioning to allow for safety and ease of shoulder manipulation. The approach using the deltopectoral interval is described, with emphasis on the proper use of retractors and adequate soft-tissue releases. Appropriate handling of the subscapularis and lesser tuberosity during both exposure and closure is imperative for a good surgical outcome. Other portions of the procedure also can be less problematic if the surgeon is familiar with certain techniques.
在接受全肩关节置换术治疗的患者中，了解一些技巧和窍门以优化患者预后是有益的。手术前，进行适当的术前规划对于确保手术顺利进行且术中无意外发现至关重要。手术开始时，要将患者置于合适的体位，以确保安全并便于对肩部进行操作。文中描述了采用三角肌胸大肌间隙的手术入路，重点强调了牵开器的正确使用和充分的软组织松解。在显露和关闭切口过程中，妥善处理肩胛下肌和小结节对于获得良好的手术效果至关重要。如果外科医生熟悉某些技术，手术的其他部分也可能会减少问题。
