Antonios Tony, Khoriati Al-Achraf, Arnander Magnus, Pearse Eyiyemi, Duncan Tennent Thomas
The Shoulder Unit, Department of Trauma and Orthopaedics, St. George's University Hospitals NHS Foundation Trust, London, UK.
JSES Rev Rep Tech. 2021 May 18;1(3):207-212. doi: 10.1016/j.xrrt.2021.04.011. eCollection 2021 Aug.
Many of the complications related to bone block augmentation for recurrent shoulder instability are related to metal screw fixation. Alternative fixation techniques using suspensory fixation have been described with good results, although they require an additional posterior incision to manage the button. It was postulated that the use of an all-suture anchor would remove the requirement for a posterior incision, whilst providing equivalent union rates. Thus, the aim of this study was to evaluate the radiological outcome of a technique using all-suture anchor fixation of iliac crest autograft.
Eleven patients (mean age 28 years, 10 males, 1 female) underwent open anterior shoulder stabilization using an autologous iliac crest bone graft that was fixed with all-suture anchors and supplemented by 2-hole tibial plate. Union of the graft was evaluated 6 months postoperatively using computed tomography.
There were no intraoperative complications and none of the participants needed further surgery. All patients reported a stable shoulder at 6 months follow-up. The grafts united in 10 out of the 11 patients.
An all-suture anchor construct is a viable alternative to metal screw fixation for iliac crest bone grafting in shoulder instability with critical bone loss, and unlike suspensory techniques does not require a second posterior incision.
复发性肩关节不稳定的骨块增强相关的许多并发症与金属螺钉固定有关。尽管使用悬吊固定的替代固定技术需要额外的后切口来处理纽扣,但已有报道称其效果良好。据推测,使用全缝线锚钉将消除对后切口的需求,同时提供相当的愈合率。因此,本研究的目的是评估使用全缝线锚钉固定髂嵴自体骨移植技术的影像学结果。
11例患者(平均年龄28岁,男10例,女1例)接受了开放性前路肩关节稳定手术,使用全缝线锚钉固定自体髂嵴骨移植,并辅以双孔胫骨钢板。术后6个月使用计算机断层扫描评估移植骨的愈合情况。
术中无并发症,所有参与者均无需进一步手术。所有患者在6个月随访时均报告肩关节稳定。11例患者中有10例移植骨愈合。
对于伴有严重骨丢失的肩关节不稳定的髂嵴骨移植,全缝线锚钉结构是金属螺钉固定的可行替代方案,并且与悬吊技术不同,不需要第二个后切口。