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肩胛盂骨折的解剖复位与固定:“亲吻锚定”技术

Anatomic Reduction and Fixation for Glenoid Fractures: The Kissing Anchor Technique.

作者信息

Gervasi Enrico, Dei Giudici Luca, Spicuzza Alessandro

机构信息

Orthopedic Unit, Casa di Cura "Giovanni XXIII" Hospital, Monastier di Treviso, Italy.

Orthopedic Unit, Casa di Cura "Villa Igea" Hospital, Ancona, Italy.

出版信息

Arthrosc Tech. 2020 Aug 1;9(8):e1095-e1100. doi: 10.1016/j.eats.2020.04.006. eCollection 2020 Aug.

DOI:10.1016/j.eats.2020.04.006
PMID:32874888
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7451734/
Abstract

Up to one fifth of glenoid fractures are intra-articular and associated with recurrent anterior dislocation. Surgery is often the indicated treatment, and as with many other articular fractures, it aims for a perfectly congruent and flush reconstruction of the articular surface to avoid the onset of secondary degenerative joint diseases. The purpose of this paper is to describe a reproducible, simple arthroscopic technique that uses suture anchors to fix the glenoid fragment with a strong and stable construct called "kissing anchors." This method provides the advantages of both direct and indirect stabilizing effects. It applies 2 anchors, one inside the fragment and the other inside the fracture bed, to stabilize and fix the fragment, and is adequately associated with labrum refixation, which provides the construct with increased stability. However, a surgeon willing to apply it should already be confident with basic shoulder arthroscopy and should have performed an appropriate amount of arthroscopic shoulder stabilizations.

摘要

高达五分之一的肩胛盂骨折为关节内骨折,并伴有复发性前脱位。手术通常是指定的治疗方法,与许多其他关节骨折一样,其目的是实现关节面的完美贴合和齐平重建,以避免继发性退行性关节疾病的发生。本文的目的是描述一种可重复、简单的关节镜技术,该技术使用缝合锚钉以一种称为“吻合锚钉”的坚固稳定结构固定肩胛盂碎片。这种方法具有直接和间接稳定作用的优点。它应用2个锚钉,一个置于碎片内,另一个置于骨折床内,以稳定和固定碎片,并与盂唇重新固定充分结合,从而为该结构提供更高的稳定性。然而,愿意应用该技术的外科医生应该已经对基本的肩关节镜检查有信心,并且应该已经进行了适量的关节镜下肩关节稳定手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/01392f7bb3f0/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/960f2f1b021e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/c266aa9e55ac/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/1c087a6311a5/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/78aaa0ab1323/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/e2edb001af52/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/01392f7bb3f0/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/960f2f1b021e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/c266aa9e55ac/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/1c087a6311a5/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/78aaa0ab1323/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/e2edb001af52/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f2/7451734/01392f7bb3f0/gr6.jpg

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本文引用的文献

1
Arthroscopic repair of glenoid rim fractures: a ligamentotaxis surgical technique.关节镜下修复肩胛盂边缘骨折:一种韧带牵引手术技术。
Musculoskelet Surg. 2018 Oct;102(Suppl 1):41-48. doi: 10.1007/s12306-018-0558-4. Epub 2018 Oct 20.
2
Arthroscopic management of articular and peri-articular fractures of the upper limb.上肢关节内及关节周围骨折的关节镜治疗
EFORT Open Rev. 2017 Mar 13;1(9):325-331. doi: 10.1302/2058-5241.1.160016. eCollection 2016 Sep.
3
Arthroscopic reduction and fixation of large solitary and multifragmented anterior glenoid rim fractures.
关节镜下复位及固定大型孤立性和多块性前盂缘骨折
J Shoulder Elbow Surg. 2016 May;25(5):781-90. doi: 10.1016/j.jse.2015.09.012. Epub 2015 Dec 2.
4
Arthroscopic transosseous bony bankart repair.关节镜下经骨骨性Bankart损伤修复术
Arthrosc Tech. 2015 Feb 2;4(1):e47-50. doi: 10.1016/j.eats.2014.11.001. eCollection 2015 Feb.
5
Glenoid fractures: a review of pathology, classification, treatment and results.肩胛盂骨折:病理学、分类、治疗及结果综述
Acta Orthop Belg. 2014 Mar;80(1):88-98.
6
Arthroscopic screw fixation of large anterior glenoid fractures.大型肩胛盂前部骨折的关节镜下螺钉固定术
Knee Surg Sports Traumatol Arthrosc. 2008 Mar;16(3):326-32. doi: 10.1007/s00167-007-0437-2. Epub 2007 Nov 14.
7
Arthroscopic repair of glenoid fractures using suture anchors.使用缝线锚钉进行关节镜下盂骨骨折修复术。
Arthroscopy. 2005 May;21(5):635. doi: 10.1016/j.arthro.2005.02.006.
8
Arthroscopic approach to acute bony Bankart lesion.关节镜下治疗急性骨性Bankart损伤的方法。
Arthroscopy. 2002 Sep;18(7):764-9. doi: 10.1053/jars.2002.35266.