Ramsay Générale de Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Unité de l'épaule, Lyon, France.
Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
JBJS Case Connect. 2020 Apr-Jun;10(2):e0322. doi: 10.2106/JBJS.CC.19.00322.
A 30-year-old woman with an irreparable subscapularis tear presented with persistent painful anterior instability despite several open and arthroscopic stabilization procedures. A pectoralis major tendon transfer (PMTT) was performed. The patient subsequently developed progressive glenohumeral arthritis over the next 10 years, ultimately necessitating shoulder arthroplasty.
PMTT provides valuable anterior soft-tissue reconstruction stabilization for subscapularis insufficiency in a multioperated shoulder. Ten years later, the transfer was found to be intact and managed like a native subscapularis during anatomic shoulder replacement, thus avoiding a reverse arthroplasty in a young patient.
一名 30 岁女性,因不可修复的肩胛下肌撕裂,尽管进行了多次开放性和关节镜稳定手术,但仍持续存在疼痛性前向不稳定。进行了胸大肌肌腱转移(PMTT)。随后,患者在接下来的 10 年内逐渐出现肩肱关节炎,最终需要进行肩关节置换。
PMTT 为多手术肩部的肩胛下肌不足提供了有价值的前侧软组织重建稳定。10 年后,该转移肌腱仍完整,并在解剖型肩关节置换中像原生肩胛下肌一样处理,从而避免了年轻患者的反向关节置换。