Qian Hong, Yang Xiaojiang, Lv Zhongyang, Yu Shao, Lu Jingwei, Liu Jichun, Bao Ninrong
Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.
Department of Education and Support, Army Engineering University of PLA, Nanjing, China.
Arthrosc Tech. 2024 Nov 14;14(3):103276. doi: 10.1016/j.eats.2024.103276. eCollection 2025 Mar.
The anatomic repair of delaminated rotator cuff tears presents a surgical challenge, necessitating innovative solutions for optimal outcomes. This Technical Note describes the arthroscopic suture bridge combined with all-inside fixation, a novel approach tailored for small yet deep-layer dominant delaminated tears. The method involves addressing the upper-layer tear beneath the acromion and employing all-inside suturing in the glenohumeral joint for the lower-layer tear, decoupling the outer tear size from limiting the treatment of the deeper tear. Accurate tear identification and preoperative planning are critical for success. This technique offers advantages in overcoming the outer tear's impact on lower tear repair, potentially reducing patient costs. Proficiency in tear identification and surgical planning is essential for successful execution. Considerations include reserving sutures as a precaution and inapplicability to posteriorly located delaminated tears. This approach provides a valuable contribution to arthroscopic techniques, especially for smaller delaminated tears.
分层的肩袖撕裂的解剖修复是一项手术挑战，需要创新解决方案以实现最佳效果。本技术说明描述了关节镜下缝合桥联合全内固定，这是一种针对小而深层为主的分层撕裂量身定制的新方法。该方法包括处理肩峰下的上层撕裂，并在盂肱关节内对下层撕裂采用全内缝合，将外层撕裂大小与限制深层撕裂的治疗脱钩。准确识别撕裂和术前规划是成功的关键。该技术在克服外层撕裂对下层撕裂修复的影响方面具有优势，可能降低患者成本。熟练掌握撕裂识别和手术规划对于成功实施至关重要。考虑因素包括预留缝线作为预防措施以及不适用于位于后方的分层撕裂。这种方法对关节镜技术有重要贡献，特别是对于较小的分层撕裂。
