Wiley A M
Department of Surgery, Toronto Western Hospital, Ontario, Canada.
Arthroscopy. 1988;4(1):25-30. doi: 10.1016/s0749-8063(88)80007-0.
At this time the principal role of the arthroscope in the management of dislocating shoulder seems to be the identification of the intra-articular pathology. The findings should enable a surgeon to carry out an appropriate open repair, and the results of such surgery are excellent. Is there a place for arthroscopic repair? Some patients sometimes request it; others have had a failed open repair, or wish to avoid a scar. The author has devised a removable "Rivet," which fixes a loose labrum and the inferior glenohumeral ligament back on to a roughened glenoid margin. Use of this technique avoids some of the hazards that occur with implanting a staple or similar device in the joint. The "Rivet" is removed after 4-6 weeks. Ten patients have been so treated, with a follow-up of 6 months to 2 years. There was one failure, with a return of dislocation.
目前，关节镜在复发性肩关节脱位治疗中的主要作用似乎是识别关节内病变。这些发现应能使外科医生进行适当的切开修复，而且这种手术的效果非常好。关节镜修复是否有其用武之地呢？有些患者有时会要求进行关节镜修复；另一些患者则是切开修复失败，或者希望避免留下疤痕。作者设计了一种可移除的“铆钉”，它能将松弛的盂唇和肩胛下韧带重新固定在粗糙的关节盂边缘上。使用这种技术可避免在关节内植入吻合钉或类似装置时出现的一些风险。4至6周后取出“铆钉”。10名患者接受了这种治疗，随访时间为6个月至2年。有1例失败，出现了再次脱位。
