Kouvalchouk J F, Coudert X, Watin Augouard L, Da Silva Rosa R, Paszkowski A
Service de Chirurgie Orthopédique et Traumatologie du sport, C.M.C. Foch, Suresnes.
Rev Chir Orthop Reparatrice Appar Mot. 1993;79(8):661-5.
Our purpose has been to describe an original surgical technique without describing all the problems concerning the posterior instability. The original technique has a double effect: active with the muscular flap and passively mechanic, if necessary, by the bone graft. Five patients have been treated with this technique with a follow-up of one year and a half. 4 females and 1 male with an average age of 32 years 1/2. 2 were recurrent posterior instability, one unintentional and 2 intentional subluxations. 2 were epileptics. In all cases, the disparition of the instability was obtained. Full range of movement and sport were resumed at the former level. On X-rays, the humeral head was centered. By its double mechanism, active with the muscular flap and possibly passive with the bone graft, this technic is reliable to treat the majority of posterior instability. It combines the way of action searched in physiotherapy and capsulomyoplasties to center the humeral head and this one by the bone graft in case of posterior glenoid fracture or dysplasia. It doesn't have the insufficiencies of physiotherapy or capsulomyoplasties in posterior traumatic instabilities, nor from the classical bone graft over the glenoid posterior wall, cause of osteoarthritis and pain.
我们的目的是描述一种原创的手术技术，而不描述与后向不稳定相关的所有问题。该原创技术具有双重作用：通过肌肉瓣起主动作用，必要时通过骨移植起被动机械作用。已有5例患者接受了该技术治疗，随访时间为一年半。4名女性和1名男性，平均年龄为32岁半。2例为复发性后向不稳定，1例为非故意性，2例为故意性半脱位。2例为癫痫患者。在所有病例中，均实现了不稳定的消除。恢复了以前水平的全范围活动和运动。X线片显示肱骨头居中。通过其双重机制，即通过肌肉瓣起主动作用，并可能通过骨移植起被动作用，该技术对于治疗大多数后向不稳定是可靠的。它结合了物理治疗和关节囊成形术中所寻求的作用方式，以使肱骨头居中，并且在存在肩胛盂后缘骨折或发育异常的情况下通过骨移植使肱骨头居中。它不存在后向创伤性不稳定中物理治疗或关节囊成形术的不足之处，也不存在肩胛盂后壁经典骨移植导致骨关节炎和疼痛的问题。
