Li Xinning, Padmanabha Anand, Koh Justin, Cusano Antonio
Boston University School of Medicine-Boston Medical Center, Boston, Massachusetts, U.S.A.
Arthrosc Tech. 2017 Apr 3;6(2):e413-e417. doi: 10.1016/j.eats.2016.10.018. eCollection 2017 Apr.
Acromioclavicular joint injuries account for 9% of shoulder girdle injuries and are most often associated with direct blows to the shoulder or axially directed forces onto the ipsilateral extremity. Type IV, V, and VI injuries are generally managed surgically, whereas type I and II injuries are treated with sling immobilization, early shoulder range of motion, and physical therapy. Type III injuries are more controversial but are generally managed surgically in the active and high-demand patient. When surgical treatment is indicated, the primary goal of a coracoclavicular (CC) ligament reconstruction is to restore anatomic reduction of the acromioclavicular joint and reconstruct the biomechanical forces of the CC ligaments. Many open surgical techniques are currently used to achieve these goals but can increase patient morbidity. We describe a technique for an all-arthroscopic CC ligament reconstruction using a semitendinosus allograft and BioComposite tenodesis screws (Arthrex) without disruption of the deltoid attachment onto the distal clavicle.
肩锁关节损伤占肩胛带损伤的9%，最常与肩部的直接打击或同侧肢体的轴向力有关。IV型、V型和VI型损伤一般采用手术治疗，而I型和II型损伤采用吊带固定、早期肩关节活动范围训练及物理治疗。III型损伤更具争议性，但在活跃和高需求患者中一般采用手术治疗。当需要手术治疗时，喙锁（CC）韧带重建的主要目标是恢复肩锁关节的解剖复位并重建CC韧带的生物力学力量。目前有许多开放手术技术用于实现这些目标，但会增加患者的发病率。我们描述了一种全关节镜下使用半腱肌同种异体移植物和BioComposite固定螺钉（Arthrex公司）进行CC韧带重建的技术，而不破坏三角肌在锁骨远端的附着。
