关节镜下环状关节囊切开术和腋神经松解术治疗僵硬性肩关节
Management of the Stiff Shoulder With Arthroscopic Circumferential Capsulotomy and Axillary Nerve Release.
作者信息
Tao Matthew A, Karas Vasili, Riboh Jonathan C, Laver Lior, Garrigues Grant E
机构信息
Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, U.S.A.
出版信息
Arthrosc Tech. 2017 Mar 13;6(2):e319-e324. doi: 10.1016/j.eats.2016.10.005. eCollection 2017 Apr.
Abstract
Management of the stiff shoulder is a common and frequently daunting clinical scenario. Arthroscopic capsular release is usually an option for management of severe, chronic glenohumeral joint contractures when conservative treatment fails. Technical hurdles including a thickened capsule, reduction in joint volume, and difficulty with positioning the shoulder intraoperatively can make this procedure challenging. In addition, incomplete release and recalcitrant stiffness are frequent issues. We believe a complete release of the capsule entails special attention to the axillary pouch and requires identification and protection of the axillary nerve. We present a technique for a complete arthroscopic circumferential capsulotomy and detail our approach to safely dissect and protect the axillary nerve under arthroscopic visualization.
摘要
僵硬肩关节的治疗是一种常见且常常令人望而却步的临床情况。当保守治疗失败时，关节镜下关节囊松解术通常是治疗严重慢性盂肱关节挛缩的一种选择。技术难题包括增厚的关节囊、关节容积减小以及术中肩部定位困难，这些都可能使该手术具有挑战性。此外，松解不完全和顽固性僵硬是常见问题。我们认为，完全松解关节囊需要特别关注腋袋，并需要识别和保护腋神经。我们介绍一种完全关节镜下环形关节囊切开术的技术，并详细说明我们在关节镜直视下安全解剖和保护腋神经的方法。
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