Auffarth A, Kralinger F, Resch H
Department of Traumatology and Sportsinjuries, Paracelsus Medical University, Muellner- Hauptstr. 48, 5020, Salzburg, Austria.
Oper Orthop Traumatol. 2011 Dec;23(5):453-61. doi: 10.1007/s00064-011-0055-5.
To reconstruct the anatomical glenoid shape in cases of osseous glenoid rim defects after recurrent posttraumatic anterior shoulder dislocation to restore stability without severely compromising the range of motion.
Osseous glenoid defects after recurrent posttraumatic anterior shoulder dislocation. Suitable for primary stabilization as well as for revision surgery in cases previously operated on.
Recurrent anterior shoulder dislocations without glenoid rim defects. Hyperlax shoulders with multidirectional instability. Patients over 60 years of age due to compromised bone quality. Teenage patients due to incomplete apophyseal fusion at the iliac crest.
The subscapularis tendon and capsule are split. The humeral head is retracted laterally, and the glenoid defect is prepared and abraded with a rasp. A bicortical iliac crest bone block including crest and outer cortex is harvested and molded in a J-shaped manner. To incorporate the graft, a crevice on the glenoid rim is produced using a chisel. The keel is fitted into the preformed crevice with a spiked impactor. The graft's surface is contoured using a high-speed burr.
A total of 47 shoulders were followed-up after an average of 90 months (range 25-152 months). The mean Rowe scores were 94.3 for the affected shoulder and 96.8 for the uninjured shoulder. The Constant scores reached 93.5 and 95 points, respectively. Loss of external rotation was 4.4°. In addition, 24 shoulders were followed-up by computed tomography (CT). There were no recurrences, with the exception of one traumatic graft fracture. Of 19 patients with arthropathy at follow-up, 11 already had arthropathy prior to the procedure.
在复发性创伤后前肩关节脱位导致骨性肩胛盂边缘缺损的病例中重建肩胛盂的解剖形态，以恢复稳定性，同时不严重影响活动范围。
复发性创伤后前肩关节脱位导致的骨性肩胛盂缺损。适用于初次稳定手术以及既往接受过手术的病例的翻修手术。
无肩胛盂边缘缺损的复发性前肩关节脱位。伴有多向不稳定的过度松弛的肩部。60岁以上因骨质受损的患者。青少年患者因髂嵴骨骺未完全融合。
劈开肩胛下肌腱和关节囊。将肱骨头向外牵拉，用锉刀准备并打磨肩胛盂缺损处。取一块包括嵴和外层皮质的双侧髂嵴骨块，将其塑形为J形。为植入移植物，用凿子在肩胛盂边缘制造一个缝隙。用带尖的冲击器将骨块的龙骨部分嵌入预制的缝隙中。用高速磨钻对移植物的表面进行塑形。
平均随访90个月（范围25 - 152个月），共随访47例肩部。患侧肩部的平均Rowe评分为94.3分，未受伤肩部为96.8分。Constant评分分别达到93.5分和95分。外旋丧失4.4°。此外，24例肩部接受了计算机断层扫描（CT）随访。除1例移植物创伤性骨折外，无复发情况。随访时19例有关节病的患者中，11例在手术前就已有关节病。
