Sanchez Matthieu, Klouche Shahnaz, Faivre Bruno, Bauer Thomas, Hardy Philippe
Hôpitaux Universitaires Paris Ile de France Ouest, Assistance Publique-Hôpitaux de Paris, Boulogne Billancourt, France.
Université de Versailles Saint-Quentin-en-Yvelines, UFR des Sciences de la Santé, Versailles, France.
Shoulder Elbow. 2017 Oct;9(4):272-278. doi: 10.1177/1758573217693809. Epub 2017 Feb 14.
Anterior glenohumeral instability is frequently associated with anteroinferior glenoid bone defects. One original technique has been described in the literature that incorporates a J-shaped graft from the iliac crest into the anterior glenoid rim. The main goal of the present study was to evaluate the feasibility of harvesting a J-shaped graft from the acromion that corresponds to previously described dimensions. The secondary goal was to determine the ideal harvesting site.
Forty shoulders from 20 cadavers were included. Twenty grafts were harvested from the posterior acromion and 20 from the lateral acromion. The length, width and thickness of the grafts were measured. The incision was then enlarged to confirm the absence of an acromial fracture by fluoroscopic control.
Harvesting a graft whose size was similar to a J-graft was successfully performed in all cases (100%) with a mean (SD) incision of 4.2 (0.3) cm. Mean (SD) harvesting time was 4.5 (0.5) minutes. Two acromial fractures were identified during lateral harvesting (10%) and none during posterior harvesting ( = 0.49).
It is always possible to harvest a J-graft on the acromion. The posterior side of the acromion is the best site to harvest a graft that has the necessary size to treat glenoid bone defects.
肩关节前向不稳常伴有肩胛盂前下方骨缺损。文献中描述了一种原始技术，即将取自髂嵴的J形移植物植入肩胛盂前缘。本研究的主要目的是评估从肩峰获取尺寸与先前描述相符的J形移植物的可行性。次要目的是确定理想的取材部位。
纳入20具尸体的40个肩关节。20个移植物取自肩峰后部，20个取自肩峰外侧。测量移植物的长度、宽度和厚度。然后扩大切口，通过透视控制确认肩峰无骨折。
所有病例（100%）均成功获取尺寸与J形移植物相似的移植物，平均（标准差）切口长度为4.2（0.3）cm。平均（标准差）取材时间为4.5（0.5）分钟。外侧取材时发现2例肩峰骨折（10%），后侧取材时未发现骨折（P = 0.49）。
总是可以在肩峰获取J形移植物。肩峰后侧是获取具有治疗肩胛盂骨缺损所需尺寸移植物的最佳部位。
