Schon Jason M, Katthagen J Christoph, Dupre Cameron N, Mitchell Justin J, Turnbull Travis Lee, Adams Christopher R, Denard Patrick J, Millett Peter J
Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Arthroscopy. 2017 Jun;33(6):1131-1137. doi: 10.1016/j.arthro.2016.10.016. Epub 2016 Dec 31.
To investigate glenoid fixation for superior capsule reconstruction (SCR) and evaluate anchor positions, intraosseous trajectories, and proximity to the suprascapular nerve (SSN) and glenoid fossa. The secondary purpose was to provide technical pearls and pitfalls for anchor insertion on the superior glenoid during SCR.
Three beath pins were arthroscopically inserted into 12 (n = 12) nonpaired human cadaveric shoulders through Neviaser, anterior, and posterior portals to simulate anchor placement on the superior glenoid during SCR. Computed tomography scans were performed to evaluate anchor positioning and insertion trajectories. Specimens were then dissected to delineate the anatomic relations of the beath pins to the SSN and glenoid fossa.
The superior glenoid anchor position was a mean 15.0 ± 4.0 mm to the SSN and 6.5 ± 1.7 mm to the glenoid fossa. The posterior glenoid anchor position was a mean 11.8 ± 2.1 mm to the SSN and 2.9 ± 2.9 mm to the glenoid fossa. On average, the superior pin was placed at 12:30 ± 0:30 (left-sided glenoid clock face) and inserted at 19° ± 9° with respect to the sagittal plane of the glenoid, the anterior pin was placed at 11:00 ± 0:30 and inserted 40° ± 17° off the glenoid, and the posterior pin was placed at 3:00 ± 1:00 and inserted at 52° ± 12° off the glenoid.
The results of the present cadaveric study showed that glenoid fixation was safe with respect to the SSN and delineated technical guidelines and trajectories for inserting 3 anchors into the glenoid.
This study shows that 3 anchors can be inserted into the glenoid without a risk of SSN damage and delineates technical guidelines for anchor insertion.
研究用于上盂唇重建（SCR）的肩胛盂固定，评估锚钉位置、骨内轨迹以及与肩胛上神经（SSN）和肩胛盂窝的距离。次要目的是提供SCR过程中在上肩胛盂插入锚钉的技术要点和陷阱。
通过Neviaser入路、前入路和后入路，在关节镜下将三根导针插入12具（n = 12）非配对的人体尸体肩部，以模拟SCR过程中在上肩胛盂放置锚钉。进行计算机断层扫描以评估锚钉定位和插入轨迹。然后解剖标本，描绘导针与SSN和肩胛盂窝的解剖关系。
上肩胛盂锚钉位置距SSN平均为15.0±4.0毫米，距肩胛盂窝平均为6.5±1.7毫米。后肩胛盂锚钉位置距SSN平均为11.8±2.1毫米，距肩胛盂窝平均为2.9±2.9毫米。平均而言，上方导针置于12:30±:30（左侧肩胛盂钟面），相对于肩胛盂矢状面以19°±9°插入，前方导针置于11:00±:30，偏离肩胛盂40°±17°插入，后方导针置于3:00±1:00，偏离肩胛盂52°±12°插入。
本尸体研究结果表明，肩胛盂固定相对于SSN是安全的，并描绘了将3枚锚钉插入肩胛盂的技术指南和轨迹。
本研究表明，可以将3枚锚钉插入肩胛盂而无SSN损伤风险，并描绘了锚钉插入的技术指南。
