肱骨头部缺损和肩胛盂轨道的处理。
Management of humeral head deficiencies and glenoid track.
机构信息
Department of Orthopaedic Surgery, Concordia Hospital for "Special Surgery", Via delle Sette Chiese, 9000145, Roma, Italy,
出版信息
Curr Rev Musculoskelet Med. 2014 Mar;7(1):6-11. doi: 10.1007/s12178-013-9194-7.
Abstract
When considering the management of shoulder anterior instability with glenoid bone loss ≥25 % of the inferior glenoid diameter (inverted-pear glenoid), the consensus among recent authors is that glenoid bone grafting should be done. Although the engaging Hill-Sachs lesion has been recognized as a risk factor for recurrent anterior instability, there has been no generally accepted methodology for quantifying the Hill-Sachs lesion taking into account the geometric interplay of various sizes and various orientations of bipolar (humeral-sided plus glenoid-sided) bone loss. Keeping the glenoid track concept in mind, if a Hill-Sachs lesion engages the anterior glenoid rim, with or without concomitant anterior glenoid bone loss, it is possible to manage this pathology, reducing the risk of recurrent shoulder instability after surgery. If the Hill-Sachs engages, "Remplissage" or "Latarjet" surgical procedures are indicated depending of glenoid bone loss.
摘要
在考虑伴有下盂肱径（倒梨形）≥25%的关节盂骨丢失的肩前不稳定的处理时，最近的作者的共识是应该进行关节盂骨移植。虽然啮合的 Hill-Sachs 病变已被认为是复发性前不稳定的危险因素，但对于考虑到各种大小和双极（肱骨头侧加关节盂侧）骨丢失的各种方向的几何相互作用的 Hill-Sachs 病变的定量方法，尚未达成普遍接受的方法。牢记关节盂轨迹的概念，如果 Hill-Sachs 病变啮合前关节盂边缘，无论是否伴有前关节盂骨丢失，都可以处理这种病理，降低手术后复发性肩不稳定的风险。如果 Hill-Sachs 病变啮合，根据关节盂骨丢失情况，可选择“填充”或“Latarjet”手术。
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