Björkenheim J M, Paavolainen P, Ahovuo J, Slätis P
Division of Orthopaedics and Traumatology, Surgical Hospital, University Central Hospital, Helsinki, Finland.
Clin Orthop Relat Res. 1990 Mar(252):150-5.
Symptomatic (Stage II) impingement of the rotator cuff against the coracoacromial arch has been treated with anterior acromioplasty in 60 shoulders in 56 patients. Patient selection is crucial. Arthrography of the shoulder was routinely included in the preoperative diagnostic tools to rule out a tear of the rotator cuff. Since acromial shape may play a role producing a resistant impingement syndrome, special attention should be paid to patients with Type III of acromial inclination. The surgical procedure should include a thorough examination of the subacromial space as a whole, taking notice of all pathologic findings in the subacromial arch as well as in the underlying soft tissues. Restoring subacromial clearance, the patients were relieved of their symptoms. The result, rated according to the functional assessment of Neer, was excellent or satisfactory in 73%. Failure to recognize the associated bony as well as soft-tissue subacromial lesions was, however, a frequent cause of failure of surgical decompression operations.
56例患者60个肩部因肩袖撞击喙肩弓出现症状（Ⅱ期），均接受了前路肩峰成形术治疗。患者选择至关重要。术前诊断工具常规包括肩部关节造影，以排除肩袖撕裂。由于肩峰形态可能在产生抵抗性撞击综合征中起作用，因此应特别关注肩峰倾斜Ⅲ型患者。手术过程应包括对整个肩峰下间隙进行全面检查，注意肩峰下弓以及下方软组织中的所有病理发现。恢复肩峰下间隙后，患者症状得到缓解。根据Neer功能评估，结果为优或良的占73%。然而，未能识别相关的骨性以及肩峰下软组织病变是手术减压操作失败的常见原因。
