Cagle Paul J, Reizner Wayne, Parsons Bradford O
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Shoulder Elbow. 2019 Dec;11(6):459-464. doi: 10.1177/1758573218793904. Epub 2018 Aug 27.
Recent trends have illustrated the benefits of treating displaced fractures of the proximal humerus with reverse total shoulder arthroplasty. Clinical results have demonstrated reliable restoration of function in situations where results following hemiarthroplasty have been variable and difficult to predict. Data have demonstrated landmarks to assist with humeral stem height in hemiarthroplasty. However, intraoperative landmarks to guide placement of the humeral component in reverse shoulder arthroplasty have not been described. In this technique, the superior border of the pectoralis tendon is utilized. A distance of 5.0 cm is used to assist in placement of the most superior aspect of the metallic humeral component and with humeral stem version. This technique can be used as a guide to assist a treating physician in situations where bony fracture and comminution make humeral stem height placement difficult to judge.
近期趋势已表明采用反式全肩关节置换术治疗肱骨近端移位骨折的益处。临床结果显示，在半关节置换术效果多变且难以预测的情况下，该方法能可靠地恢复功能。数据已表明在半关节置换术中有助于确定肱骨干高度的标志。然而，尚未有关于在反式肩关节置换术中指导肱骨组件放置的术中标志的描述。在本技术中，使用胸肌腱的上缘。5.0厘米的距离用于辅助放置金属肱骨组件的最上缘以及确定肱骨干的旋转角度。在骨折和粉碎使肱骨干高度放置难以判断的情况下，该技术可作为指导，协助治疗医生进行操作。
