Gerber C, Terrier F, Ganz R
Department of Orthopaedics, University of Bern, Switzerland.
J Bone Joint Surg Br. 1988 Jan;70(1):130-4. doi: 10.1302/0301-620X.70B1.3339045.
In the Trillat procedure for recurrent anterior instability of the shoulder the coracoid process is osteotomised and tilted downward to act as a bone block, and a screw is used to fix it and the Bankart lesion to the anterior scapular neck. We reviewed 52 cases after a mean follow-up of 69 months. Results in 73% of shoulders were excellent, 10% were good, 7% fair and 10% poor. Dislocation recurred in 4%, but a positive apprehension sign was present in 10 other shoulders. Some degenerative changes were seen in 62% of shoulders, a complication known to be associated with bone-block procedures. The most important reason for loss of lateral rotation was iatrogenic impingement of the coracoid. This frequent and potentially serious complication can also cause posterior subluxation of the humeral head and osteoarthritis.
在治疗复发性肩关节前向不稳的Trillat手术中，喙突被截骨并向下倾斜作为骨块，使用螺钉将其与肩胛盂唇前下缺损（Bankart损伤）固定于肩胛颈前方。我们回顾了52例患者，平均随访69个月。结果显示，73%的肩关节疗效为优，10%为良，7%为可，10%为差。4%的患者出现脱位复发，但另有10例肩关节存在阳性恐惧试验征。62%的肩关节出现了一些退变改变，这是一种与骨块手术相关的并发症。外旋丧失的最重要原因是喙突的医源性撞击。这种常见且潜在严重的并发症还可导致肱骨头后脱位和骨关节炎。
