Postacchini F
1a Clinica Ortopedica dell'Università La Sapienza, Roma.
Ital J Orthop Traumatol. 1989 Mar;15(1):15-24.
Eighteen cases of coracoacromial attribution syndrome submitted to operative treatment over a 5-year period are analysed. Three types of syndrome were identified. The attrition manoeuvre was positive in all cases and, in 16, infiltration of local anaesthetic in the subacromial bursa abolished or considerably decreased the pain. The most frequent operative findings were excessive thickness of the acromion, sometimes associated with osteophytosis of the anterior margin of the bone, and inspissation of the subacromial bursa; in 3 cases there were fissures or lacerations of the bursal surface of the supraspinatus. In all patients the coracoacromial ligament was sectioned, horizontal osteotomy of the acromion performed and the subacromial bursa removed. When necessary, cheilotomy of the acromioclavicular joint was performed, and any partial lacerations of the cuff repaired. The results were satisfactory in 15 cases and fair in 3, and were directly related to the positivity of the attrition test and to the severity of the anatomical, coracoacromial and rotator cuff lesions observed at operation.
分析了5年间接受手术治疗的18例喙肩撞击综合征病例。确定了3种综合征类型。所有病例的撞击试验均为阳性，16例中，肩峰下囊内注射局部麻醉剂可消除或显著减轻疼痛。最常见的手术发现是肩峰过度增厚，有时伴有骨前缘骨质增生，以及肩峰下囊增厚；3例冈上肌滑囊面有裂隙或撕裂。所有患者均切断喙肩韧带，行肩峰水平截骨并切除肩峰下囊。必要时，行肩锁关节切开术，并修复袖带的任何部分撕裂。15例结果满意，3例一般，结果与撞击试验阳性以及手术中观察到的解剖、喙肩和肩袖损伤的严重程度直接相关。
