Carlson Strother Courtney R, McLaughlin Richard J, Krych Aaron J, Sanchez-Sotelo Joaquin, Camp Christopher L
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Arthrosc Tech. 2019 Jul 4;8(7):e749-e754. doi: 10.1016/j.eats.2019.03.011. eCollection 2019 Jul.
Although anterior shoulder instability is most commonly treated with arthroscopic fixation, open labral repair with capsular shift may be best for select patients and in cases of revision stabilization without significant bone loss. The technique described in this article uses the deltopectoral interval; it involves careful dissection of the subscapularis from the anterior capsule, repair of the Bankart lesion, and a lateral and superior capsular shift using all-suture anchors in the humeral head. Advantages of this technique include meticulous control of anchor placement and the ability to provide additional stability via a lateral and superiorly directed capsular shift. This operation can be performed in a reliable, efficient, and reproducible manner.
尽管肩关节前不稳定最常采用关节镜下固定治疗,但对于特定患者以及在无明显骨质丢失的翻修稳定病例中,开放盂唇修复联合关节囊移位可能是最佳选择。本文所述技术采用三角肌胸大肌间隙;它包括从前侧关节囊仔细分离肩胛下肌、修复Bankart损伤以及使用全缝线锚钉在肱骨头进行外侧和上方关节囊移位。该技术的优点包括对锚钉放置的精确控制以及通过外侧和上方定向的关节囊移位提供额外稳定性的能力。该手术可以以可靠、高效且可重复的方式进行。