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肩上部悬吊复合体多处断裂:一例报告

Multiple disruptions of superior suspensory shoulder complex: A case report.

作者信息

Nguyen Manh Khanh, Nguyen Van Hoc, Le Hoang Gia Khoa, Cao Dinh Bang

机构信息

Upper Extremities Surgery and Sports Medicine Department, Viet Duc University Hospital, Hanoi, Viet Nam.

Upper Extremities Surgery and Sports Medicine Department, Viet Duc University Hospital, Hanoi, Viet Nam.

出版信息

Int J Surg Case Rep. 2024 Nov;124:110385. doi: 10.1016/j.ijscr.2024.110385. Epub 2024 Sep 30.

DOI:10.1016/j.ijscr.2024.110385
PMID:39393295
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11562406/
Abstract

INTRODUCTION

The superior shoulder suspensory complex (SSSC) is a ligamentous anatomical structure that maintains shoulder girdle stability. It comprises a ring of bones and tissues, including the glenoid fossa, coracoid process (CP), coracoclavicular ligaments, distal clavicle, acromioclavicular (AC) joint, and acromion. Goss first described the structure in 1993. Disruption in two or more structures results in an unstable lesion. This report presents a rare case of triple disruption of the acromion, CP, and AC joint. Triple disruption of the SSSC is uncommon; therefore, the treatment is debatable. In our case, surgical intervention was performed to fix the instability of the shoulder girdle, which improved the patient's shoulder function.

CASE PRESENTATION

A 43-year-old woman presented with an acromial fracture, a CP fracture, and dislocation of the AC joint after a traffic accident. The patient underwent surgery and postoperative rehabilitation.

DISCUSSION

Several treatment options exist for multiple disruptions of the shoulder stabilizing SSSC, including K-wire fixation, plate fixation, or arthroscopic-assisted devices. As the patient's acromion size was smaller than the average female acromion, K-wire fixation was deemed the most suitable method.

CONCLUSION

Multiple disruptions of the SSSC are rare and typically result from high-velocity injuries. Surgical treatment should be tailored to the specific injury patterns and the individual patient's condition.

摘要

引言

肩上部悬吊复合体(SSSC)是一种维持肩胛带稳定性的韧带解剖结构。它由一圈骨骼和组织组成,包括关节盂、喙突(CP)、喙锁韧带、锁骨远端、肩锁(AC)关节和肩峰。戈斯于1993年首次描述了该结构。两个或更多结构的破坏会导致不稳定损伤。本报告介绍了一例罕见的肩峰、喙突和肩锁关节三联损伤病例。SSSC的三联损伤并不常见;因此,治疗方法存在争议。在我们的病例中,进行了手术干预以修复肩胛带的不稳定,从而改善了患者的肩部功能。

病例介绍

一名43岁女性在交通事故后出现肩峰骨折、喙突骨折和肩锁关节脱位。患者接受了手术及术后康复治疗。

讨论

对于稳定肩部的SSSC多处损伤存在多种治疗选择,包括克氏针固定、钢板固定或关节镜辅助器械。由于患者的肩峰尺寸小于女性平均肩峰尺寸,克氏针固定被认为是最合适的方法。

结论

SSSC多处损伤罕见,通常由高速损伤引起。手术治疗应根据具体损伤模式和个体患者情况进行定制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/6b8af7a02046/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/be41b059332f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/19e872b44954/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/c5d37dfe3abe/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/7381ec0fce15/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/6b8af7a02046/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/be41b059332f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/19e872b44954/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/c5d37dfe3abe/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/7381ec0fce15/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e00/11562406/6b8af7a02046/gr5.jpg

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本文引用的文献

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Triple Disruption of the Superior Shoulder Suspensory Complex - Review and Surgical Technique.肩峰上悬吊复合体三重损伤——综述与手术技术
J Orthop Case Rep. 2023 Jun;13(6):121-126. doi: 10.13107/jocr.2023.v13.i06.3720.
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Surgical management of multiple superior shoulder suspensory complex disruptions involving at least a coracoid fracture and an acromioclavicular dislocation: A report of five cases.涉及至少一处喙突骨折和肩锁关节脱位的多例肩上方悬吊复合体损伤的手术治疗:5例报告
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SCARE 2023 指南:更新共识外科病例报告(SCARE)指南。
Int J Surg. 2023 May 1;109(5):1136-1140. doi: 10.1097/JS9.0000000000000373.
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Anatomic Restoration of Triple Disruption of the Superior Shoulder Suspensory Complex: A Case Report and Review of the Literature.解剖重建肩锁胸三角完全性损伤:病例报告及文献复习。
Orthop Surg. 2020 Oct;12(5):1526-1530. doi: 10.1111/os.12764. Epub 2020 Sep 25.
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Morphometric Evaluation of Adult Acromion Process in North Indian Population.印度北部人群成人肩峰的形态计量学评估
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