Gosselin Michelle M, Denney Brandon S, Gregory James M
Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, Texas, USA.
McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Arthrosc Tech. 2022 Apr 25;11(5):e895-e901. doi: 10.1016/j.eats.2022.01.008. eCollection 2022 May.
Acromioclavicular joint injuries are a common shoulder injury encountered by orthopaedic surgeons. Many different surgical techniques have been described for the operative treatment of these injuries with no single, clear gold standard technique on which surgeons agree. Among the most common complications after surgical management of acromioclavicular injuries are loss of reduction, infection, fracture of clavicle or coracoid, and need for reoperation. We propose an arthroscopic-assisted, tunnel-free surgical technique using a tibialis anterior allograft combined with a FiberTape Cerclage (Arthrex, Naples, FL) to manage both acute and chronic acromioclavicular joint injuries. No bony tunnels are drilled and no hardware is implanted, which should obviate the risk for subsequent bony failure through a fracture, nor require subsequent hardware removal. In addition, the combination of suspensory and allograft fixation should impart sufficient stability to maintain an adequate reduction even in the face of failure of one of the fixation methods.
肩锁关节损伤是骨科医生常见的肩部损伤。针对这些损伤的手术治疗，已经描述了许多不同的手术技术，但没有一种单一、明确的金标准技术能得到外科医生的一致认可。肩锁关节损伤手术治疗后最常见的并发症包括复位丢失、感染、锁骨或喙突骨折以及再次手术的需要。我们提出一种关节镜辅助、无隧道的手术技术，使用胫骨前异体移植物联合纤维带环扎术（Arthrex，那不勒斯，佛罗里达州）来治疗急性和慢性肩锁关节损伤。不钻骨隧道，不植入硬件，这应消除随后因骨折导致骨失败的风险，也不需要随后取出硬件。此外，悬吊和异体移植固定的组合应赋予足够的稳定性，即使在一种固定方法失败的情况下也能维持充分的复位。
