From the Mallinckrodt Institute of Radiology, Musculoskeletal Section, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110.
Radiographics. 2018 Jan-Feb;38(1):149-168. doi: 10.1148/rg.2018170061. Epub 2017 Nov 22.
Many radiologists are familiar with the preoperative imaging assessment of patients with labral tears, rotator cuff abnormalities, and end-stage arthritis, as well as the subsequent primary reconstructions and repairs commonly encountered in routine clinical management. However, the second-line surgical procedures and augmentation procedures performed for refractory or recurrent shoulder instability and the extra-articular surgical procedures of the shoulder girdle may challenge even the most experienced musculoskeletal radiologist. Knowledge of the indications, surgical techniques, expected postoperative imaging appearance, and complications of these uncommon shoulder girdle reconstructions and repairs will aid the radiologist in both the pre- and postoperative assessment of the injured shoulder. This article is divided into two parts. In the first part, procedures performed for shoulder instability are addressed, including capsular shift, Bristow-Latarjet coracoid transfer, remplissage, and humeral head allografts. In the second part, the imaging findings of extra-articular procedures of the shoulder girdle are reviewed, including biceps tenodesis, os acromiale fixation, and coracoclavicular ligament reconstruction. RSNA, 2017.
许多放射科医生熟悉盂唇撕裂、肩袖异常和终末期关节炎患者的术前影像学评估,以及在常规临床管理中常见的后续初次重建和修复。然而,对于难治性或复发性肩关节不稳定的二线手术程序和增强程序,以及肩带的关节外手术程序,即使是经验最丰富的肌肉骨骼放射科医生也可能会感到挑战。了解这些罕见的肩带重建和修复的适应证、手术技术、预期的术后影像学表现和并发症将有助于放射科医生在受伤肩关节的术前和术后评估。本文分为两部分。在第一部分中,介绍了用于肩关节不稳定的手术程序,包括囊膜移位、Bristow-Latarjet 喙突转移、填充和肱骨异体移植物。在第二部分中,回顾了肩带关节外手术的影像学发现,包括肱二头肌肌腱固定术、肩峰骨固定术和喙锁韧带重建术。RSNA,2017 年。