Young Bradley L, Karas Spero G
Division of Sports Medicine, Department of Orthopaedic Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.
Video J Sports Med. 2023 May 24;3(3):26350254231160429. doi: 10.1177/26350254231160429. eCollection 2023 May-Jun.
Shoulder instability with critical bipolar bone loss can be difficult to treat. Anterior glenoid bone block augmentation and partial humeral head resurfacing is a viable option.
This procedure is indicated in patients with both critical anterior glenoid bone loss (≥20%) and an engaging Hill-Sachs lesion.
A deltopectoral approach is performed, followed by a subscapularis tenotomy. The Hill-Sachs lesion is resurfaced with a partial humeral head arthroplasty. The anterior glenoid bone loss is replaced with a prefabricated allograft. An open Bankart repair is then performed.
Three case reports give evidence that this technique is a viable surgical option for patients with critical glenoid bone loss and an engaging Hill-Sachs lesion.
DISCUSSION/CONCLUSION: Partial humeral head resurfacing, glenoid allograft augmentation, and open Bankart is a viable surgical option for patients with critical anterior glenoid bone loss and an engaging Hill-Sachs lesion.
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
伴有严重双极骨缺损的肩关节不稳定症可能难以治疗。肩胛盂前部骨块增强术和部分肱骨头表面置换术是一种可行的选择。
该手术适用于肩胛盂前部严重骨缺损（≥20%）且存在嵌顿性希尔-萨克斯损伤的患者。
采用三角肌胸大肌入路，随后进行肩胛下肌肌腱切断术。用部分肱骨头置换术修复希尔-萨克斯损伤。用预制同种异体骨移植替代肩胛盂前部的骨缺损。然后进行开放性Bankart修复术。
三个病例报告证明，该技术对于伴有严重肩胛盂骨缺损和嵌顿性希尔-萨克斯损伤的患者是一种可行的手术选择。
讨论/结论：部分肱骨头表面置换、肩胛盂同种异体骨增强术和开放性Bankart手术对于肩胛盂前部严重骨缺损且存在嵌顿性希尔-萨克斯损伤的患者是一种可行的手术选择。
作者证明已获得本出版物中出现的任何患者的同意。如果个体可能被识别，作者已随本投稿发表包含患者的豁免声明或其他书面批准形式。
