Acta Orthop Belg. 2020 Sep;86(3):497-501.
The Latarjet procedure alters scapulothoracic motion by releasing the pectoralis minor insertion to the coracoid process and by changing the vector of the conjoint tendon. The purpose of this study is to evaluate the feasibility of retaining the pectoralis minor insertion and a part of the conjoint tendon on to the remainder of the coracoid, and to evaluate the efficiency of the procedure in avoiding scapular dyskinesis, without concessions to glenohumeral stability. Since June 2017, a modification to the Latarjet procedure has been used in the treatment of posttraumatic anterior shoulder instability. The pectoralis minor insertion and a part of the conjoint tendon is retained on its anatomical position, by harvesting only the lateral part of the coracoid. We retrospectively enrolled the first 9 consecutively treated shoulders with a minimum of 6 months follow up and recorded scapulothoracic position and scapulothoracic motion, patient satisfaction, Oxford score, and Short Form (SF)-36. All patients underwent a radiographic review at final follow up. No scapular dyskinesis was observed at final follow- up. Radiographies consistently showed a bony spur at the original osteotomy site, suggesting a functional attachment of the pectoralis minor tendon to the scapula. Harvesting only the lateral part of the coracoid is technically feasible, efficient in treating anterior shoulder instability and avoids scapular dyskinesis. Level of evidence : Level IV, Retrospective Cohort study, Treatment study.
拉杰特（Latarjet）手术通过释放胸小肌到喙突的附着点并改变联合肌腱的力线来改变肩胛胸廓运动。本研究的目的是评估保留胸小肌止点和部分联合肌腱到喙突剩余部分的可行性，并评估该手术在不影响盂肱关节稳定性的情况下避免肩胛骨运动障碍的效果。自 2017 年 6 月以来，我们对拉杰特（Latarjet）手术进行了改良，用于治疗创伤后盂肱前向不稳定。通过仅采集喙突的外侧部分，保留胸小肌止点和部分联合肌腱在其解剖位置上。我们回顾性地纳入了前 9 例连续接受治疗的肩部，随访时间至少为 6 个月，并记录了肩胛胸廓位置和肩胛胸廓运动、患者满意度、牛津评分和简明健康状况量表（SF-36）。所有患者在最终随访时均进行了影像学检查。最终随访时未观察到肩胛骨运动障碍。影像学检查一致显示在原始截骨部位有一个骨赘，表明胸小肌肌腱与肩胛骨之间存在功能性附着。仅采集喙突的外侧部分在技术上是可行的，对治疗盂肱前向不稳定有效，并可避免肩胛骨运动障碍。证据水平：IV 级，回顾性队列研究，治疗研究。
