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肩峰上悬吊复合体三重损伤——综述与手术技术

Triple Disruption of the Superior Shoulder Suspensory Complex - Review and Surgical Technique.

作者信息

Jaën Matthieu, Sayer Lydie, Fornaciari Paolo

机构信息

Department of Orthopaedic Surgery, CHUV, Lausanne, Switzerland.

Department of Orthopaedic Surgery, Hôpital Pourtalès, Neuchâtel, Switzerland.

出版信息

J Orthop Case Rep. 2023 Jun;13(6):121-126. doi: 10.13107/jocr.2023.v13.i06.3720.

Abstract

INTRODUCTION

The shoulder girdle is composed of two arches, and these two arches are held together by the superior shoulder suspensory complex (SSSC), a ligamentous complex. Goss's 1993 description of the SSSC as a ring includes the glenoid, coracoid process, coracoclavicular ligaments, distal clavicle, acromioclavicular joint, and acromion. Goss also noted in a 1996 study that a rupture of the SSSC in two places can result in an unstable lesion. This case report presents an unusual association of fractures involving the coracoid process, acromion, and distal clavicle, which has rarely been reported in the literature. Indeed, a triple lesion of the SSSC is very uncommon and the treatment is still debated. Therefore, we propose a surgical technique which we believe to have provide good results.

CASE REPORT

A 54-year-old Caucasian male patient presented with Neer I distal third fracture of the clavicle, a displaced fracture of the acromion, and a fracture of the coracoid process following a left shoulder trauma after an epileptic crisis. The patient underwent surgery and has been followed for 1 year with good clinical and functional outcomes.

CONCLUSION

This case report highlights the complexity of lesions of the SSSC and the importance of determining proper surgical technique based on the type of lesion. It demonstrates that surgery combined with active rehabilitation can lead to good functional outcomes for patients with this type of injury. This report will be of interest to clinicians involved in the treatment of this type of lesion and should add a valuable treatment option for the treatment of triple disruption of the SSSC.

摘要

引言

肩胛带由两个弓组成,这两个弓由一个韧带复合体——肩上部悬吊复合体(SSSC)连接在一起。戈斯在1993年将SSSC描述为一个环,包括关节盂、喙突、喙锁韧带、锁骨远端、肩锁关节和肩峰。戈斯在1996年的一项研究中还指出,SSSC在两个部位断裂会导致不稳定损伤。本病例报告展示了一种涉及喙突、肩峰和锁骨远端骨折的罕见关联,这种情况在文献中很少有报道。事实上,SSSC的三联损伤非常罕见,其治疗方法仍存在争议。因此,我们提出一种手术技术,我们认为该技术已取得良好效果。

病例报告

一名54岁的白种男性患者,在癫痫发作后左肩受伤,出现锁骨远端三分之一处的Neer I型骨折、肩峰移位骨折和喙突骨折。该患者接受了手术,并随访了1年,临床和功能结果良好。

结论

本病例报告强调了SSSC损伤的复杂性以及根据损伤类型确定合适手术技术的重要性。它表明手术结合积极康复可使此类损伤患者获得良好的功能结果。本报告将引起参与此类损伤治疗的临床医生的兴趣,并应为SSSC三联损伤的治疗增加一种有价值的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84b/10308973/9833d1aa2d6c/JOCR-13-121-g001.jpg

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