Tom James A, Mesfin Addisu, Shah Mitesh P, Javandel Mitra, Lee Dan J, Cerynik Douglas L, Amin Nirav H
Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, PA, USA.
Department of Orthopaedic Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Anat Res Int. 2014;2014:674179. doi: 10.1155/2014/674179. Epub 2014 Mar 3.
Introduction. When using the double interval slide technique for arthroscopic repair of chronic large or massive rotator cuff tears, the posterior interval release is directed toward the scapular spine until the fat pad that protects the suprascapular nerve is reached. Injury to the suprascapular nerve can occur due to the nerve's proximity to the operative field. This study aimed to identify safe margins for avoiding injury to the suprascapular nerve. Materials and Methods. For 20 shoulders in ten cadavers, the distance was measured from the suprascapular notch to the glenoid rim, the articular margin of the rotator cuff footprint, and the lateral border of the acromion. Results. From the suprascapular notch, the suprascapular nerve coursed an average of 3.42 cm to the glenoid rim, 5.34 cm to the articular margin of the rotator cuff footprint, and 6.09 cm to the lateral border of the acromion. Conclusions. The results of this study define a safe zone, using anatomic landmarks, to help surgeons avoid iatrogenic injury to the suprascapular nerve when employing the double interval slide technique in arthroscopic repair of the rotator cuff.
引言。在使用双间隙滑动技术进行慢性大型或巨大型肩袖撕裂的关节镜修复时，后方间隙松解是朝着肩胛冈进行的，直到到达保护肩胛上神经的脂肪垫。由于肩胛上神经靠近手术区域，可能会发生该神经损伤。本研究旨在确定避免肩胛上神经损伤的安全边界。材料与方法。对10具尸体的20个肩部进行研究，测量从肩胛上切迹到关节盂边缘、肩袖足迹的关节边缘以及肩峰外侧缘的距离。结果。从肩胛上切迹起，肩胛上神经到关节盂边缘的平均距离为3.42厘米，到肩袖足迹关节边缘的平均距离为5.34厘米，到肩峰外侧缘的平均距离为6.09厘米。结论。本研究结果利用解剖标志定义了一个安全区，以帮助外科医生在采用双间隙滑动技术进行肩袖关节镜修复时避免医源性肩胛上神经损伤。
