Da Silva Adrik Z, Moverman Michael A, Yelton Mitchell, Mizels Joshua, Wheelwright John C, Joyce Christopher D, Tashjian Robert Z
Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
School of Medicine, Michigan State University College of Human Medicine, Ann Arbor, MI, USA.
JSES Rev Rep Tech. 2024 Nov 8;5(1):86-91. doi: 10.1016/j.xrrt.2024.09.008. eCollection 2025 Feb.
The utilization of free bone grafts to reconstruct large anterior glenoid defects has increased. Distal tibia allograft is commonly used due to its lack of donor site morbidity, ability to restore large bony defects, and near anatomic osteoarticular restoration. However, the intact coracoid and conjoint tendon often impair adequate visualization and access to perform an anatomic reconstruction during open free bone graft reconstruction and often requires violation of the subscapularis tendon to gain exposure. We present a surgical technique wherein we perform a coracoid osteotomy and subsequent repair to improve visualization when performing an open free glenoid bone graft in the setting when a patient has not undergone a prior coracoid transfer that does not require violation of the subscapularis tendon. This technique demonstrates excellent functional outcomes as well as radiographic healing of the coracoid osteotomy without pain or prominent hardware at the coracoid.
使用游离骨移植重建巨大的前方关节盂缺损的情况有所增加。异体胫骨远端移植因其供区并发症少、能够修复大的骨缺损以及近乎解剖学的骨关节重建能力而被广泛应用。然而，完整的喙突和联合肌腱常常会妨碍在开放游离骨移植重建过程中进行解剖重建时的充分视野暴露和操作，并且通常需要切开肩胛下肌腱以获得暴露。我们介绍一种手术技术，即在患者未接受过先前喙突转移且不需要切开肩胛下肌腱的情况下，在进行开放游离关节盂骨移植时，通过进行喙突截骨术及后续修复来改善视野暴露。该技术显示出良好的功能结果以及喙突截骨术的影像学愈合，且喙突处无疼痛或明显的内固定物。
