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肩胛上神经在 Latarjet 手术中的损伤:一项解剖学研究。

Injury of the suprascapular nerve during latarjet procedure: an anatomic study.

机构信息

Department of Surgery, Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.

出版信息

Arthroscopy. 2012 Mar;28(3):316-21. doi: 10.1016/j.arthro.2011.08.307. Epub 2011 Dec 9.

Abstract

PURPOSE

The purpose of this study was to evaluate the relation between the specific exit point of the screws securing the coracoid graft and the suprascapular nerve during the Latarjet procedure.

METHODS

Ten fresh-frozen shoulder specimens were dissected after having undergone an open Latarjet procedure.

RESULTS

The mean distance from the posterior exit site of the superior screw to the suprascapular nerve at the base of the scapular spine was only 4 mm. Two of the superior screws were directly in contact with the major branch of the suprascapular nerve, and 2 screws were also in contact with minor branches of the suprascapular nerve. As for the inferior screw, there was contact with the major branch in 1 case and with minor branches of the suprascapular nerve in 6 cases. In the axial plane, the screws were not in contact with the suprascapular nerve if the angle relative to the glenoid was less than or equal to 10°.

CONCLUSIONS

The proximity of the suprascapular nerve to the posterior glenoid rim puts this nerve at risk during insertion of the screws used for the Latarjet procedure. Placement of screws within 10° of the face of the glenoid in the axial plane is safe and will avoid the potential for suprascapular nerve injury.

CLINICAL RELEVANCE

This study quantifies the relative risk of injury to the suprascapular nerve during the Latarjet procedure.

摘要

目的

本研究旨在评估喙突移植物固定螺钉的特定出口点与肩胛上神经在 Latarjet 手术中的关系。

方法

10 个新鲜冷冻肩部标本在接受开放式 Latarjet 手术后进行解剖。

结果

上螺钉后出口点到肩胛冈基部肩胛上神经的平均距离仅为 4 毫米。其中两个上螺钉直接与肩胛上神经的主要分支接触,两个螺钉也与肩胛上神经的小分支接触。对于下螺钉,有 1 例与主要分支接触,6 例与肩胛上神经的小分支接触。在轴位平面,如果相对于关节盂的角度小于或等于 10°,螺钉与肩胛上神经没有接触。

结论

肩胛上神经靠近关节盂后缘,在插入 Latarjet 手术用螺钉时会使该神经处于危险之中。在轴位平面上,螺钉与关节盂前表面的夹角小于 10°是安全的,可避免肩胛上神经损伤的潜在风险。

临床相关性

本研究量化了 Latarjet 手术中肩胛上神经损伤的相对风险。

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