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背阔肌和大圆肌联合全关节镜下转移治疗不可修复的肩袖后上部分撕裂

Combined Fully Arthroscopic Transfer of Latissimus Dorsi and Teres Major for Treatment of Irreparable Posterosuperior Rotator Cuff Tears.

作者信息

Kany Jean, Selim Hisham Anis

机构信息

Clinique de l'Union, Saint Jean, Toulouse, France.

Shoulder Arthroscopy and Sports Medicine Unit, Orthopedics Department, Zagazig University Hospitals, Zagazig, Egypt.

出版信息

Arthrosc Tech. 2019 Dec 24;9(1):e147-e157. doi: 10.1016/j.eats.2019.09.008. eCollection 2020 Jan.

Abstract

Many treatment options have been proposed for treatment of irreparable posterosuperior rotator cuff tears. Among these options, latissimus dorsi tendon transfer can be considered a good alternative, especially in young patients before development of glenohumeral arthritic changes, aiming at rebalancing the shoulder with a functioning subscapularis muscle and restoring both active external rotation and elevation with the aid of a properly functioning deltoid muscle. The technique was recently adapted from open to arthroscopically assisted with numerous advantages. We propose a combined fully arthroscopic technique for transfer of latissimus dorsi and teres major in which the tendons are fixed in a flat manner at the junction of supraspinatus and infraspinatus to decrease failure rate.

摘要

针对不可修复的肩袖后上部分撕裂,已经提出了许多治疗方案。在这些方案中,背阔肌肌腱转移可被视为一种不错的选择,尤其是对于尚未出现盂肱关节关节炎改变的年轻患者,其目的是通过正常发挥功能的肩胛下肌来重新平衡肩部,并借助正常发挥功能的三角肌恢复主动外旋和抬高功能。该技术最近从开放手术改进为关节镜辅助手术,具有诸多优点。我们提出一种用于背阔肌和大圆肌转移的全关节镜联合技术,即将肌腱以平整的方式固定在冈上肌和冈下肌的交界处,以降低失败率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3a/6993265/3395ff437245/gr1.jpg

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