McHale Kevin J, Sanchez George, Lavery Kyle P, Rossy William H, Sanchez Anthony, Ferrari Marcio B, Provencher Matthew T
Penn Orthopaedics, Cape Regional Medical Center, Cape May Court House, New Jersey, U.S.A.
Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
Arthrosc Tech. 2017 Jun 19;6(3):e791-e799. doi: 10.1016/j.eats.2017.02.009. eCollection 2017 Jun.
Anterior glenohumeral instability is a common clinical entity, particularly among young athletic patient populations. Nonoperative management and arthroscopic treatment of glenohumeral instability have been associated with high rates of recurrence, particularly in the setting of glenohumeral osseous defects. Coracoid transfer, particularly the Latarjet procedure, has become the treatment of choice for recurrent anterior glenohumeral instability in the setting of osseous deficiencies greater than 20% to 30% of the glenoid surface area and may also be considered for the primary treatment of recurrent instability in the high-risk contact athlete, even in the setting of limited osseous deficiency. The following Technical Note provides a diagnostic approach for suspected glenohumeral instability, as well as a detailed description of the congruent-arc Latarjet procedure, performed with a deltoid split, with its postoperative management.
肩关节前向不稳是一种常见的临床病症,在年轻的运动员人群中尤为常见。非手术治疗和关节镜治疗肩关节不稳的复发率较高,尤其是在存在肩关节骨质缺损的情况下。喙突转移术,特别是Latarjet手术,已成为治疗关节盂表面积骨质缺损超过20%至30%的复发性肩关节前向不稳的首选方法,对于高风险接触性运动员复发性不稳的初始治疗,即使骨质缺损有限,也可考虑采用该方法。以下技术说明提供了疑似肩关节不稳的诊断方法,以及采用三角肌劈开的全等弧Latarjet手术的详细描述及其术后管理。