Matthews L S, Zarins B, Michael R H, Helfet D L
Arthroscopy. 1985;1(1):33-9. doi: 10.1016/s0749-8063(85)80076-1.
A posterior portal site has become the accepted standard for introduction of the arthroscope for routine diagnostic procedures of the shoulder. Few published guidelines exist, however, on the optimum and safe positions of accessory portals for introduction of a probe or surgical instruments during shoulder arthroscopy. The relatively thick surrounding muscle layers and the close proximity of vital neurovascular structures would make guidelines for safer and more reproducible accessory portal selection helpful to minimize the risk of injury to these structures. The "intraarticular triangle" bounded by the humeral head, the glenoid rim, and the biceps tendon has been found to be an excellent intraarticular landmark for placement of an accessory anterior portal for shoulder arthroscopy. Anatomical dissections on 20 cadaver shoulders have confirmed that instruments passed through this location are at little risk to injure adjacent neurovascular structures about the shoulder. Clinical data in 30 shoulder arthroscopies performed utilizing this landmark for placement of an anterior portal have confirmed this position to be a safe and useful location for portal placement if proper precautions are followed.
后入路部位已成为在肩部常规诊断操作中引入关节镜的公认标准。然而，关于在肩关节镜检查期间用于引入探针或手术器械的辅助入路的最佳和安全位置，几乎没有已发表的指南。相对较厚的周围肌肉层以及重要神经血管结构的紧密相邻，使得关于更安全且可重复的辅助入路选择的指南有助于将损伤这些结构的风险降至最低。由肱骨头、关节盂边缘和肱二头肌肌腱界定的“关节内三角”已被发现是用于肩关节镜检查辅助前入路放置的极佳关节内标志。对20具尸体肩部进行的解剖证实，通过该位置插入的器械损伤肩部周围相邻神经血管结构的风险很小。在30例利用该标志放置前入路的肩关节镜检查中的临床数据证实，如果遵循适当的预防措施，该位置是入路放置的安全且有用的位置。
