Davidson P A, Tibone J E
Tampa Bay Orthopaedic Specialists, St. Petersburg, Florida 33709, USA.
Arthroscopy. 1995 Oct;11(5):519-25. doi: 10.1016/0749-8063(95)90126-4.
The present study describes an anterior-inferior portal for arthroscopic shoulder instrumentation at the 5 o'clock position along the glenoid rim. An anterior-inferior portal was established in 14 cadaver shoulders. The portal was created in an inside-to-outside fashion, with the humerus maximally adducted, directing the guide rod as far lateral as possible. Using the described technique, a 5 o'clock portal travels through the subscapularis and lateral to the conjoined tendon. Distance between the portal and the musculocutaneous nerve was 22.9 +/- 4.9 mm (mean +/- SD), and 24.4 +/- 5.7 mm between the portal and the axillary nerve. Previously described portals were either at, or above the 3 o'clock position, resulting in an acute, difficult angle of approach to the glenoid neck. Through a combination of proper arm positioning and rod insertion technique, the 5 o'clock portal can be created safely and is of great potential utility for arthroscopic shoulder stabilization procedures.
本研究描述了一种用于关节镜下肩部器械操作的前下入口，位于沿肩胛盂边缘的5点钟位置。在14具尸体肩部建立了前下入口。该入口以由内向外的方式创建，使肱骨最大限度内收，将导杆尽可能向外侧引导。采用所述技术，5点钟入口穿过肩胛下肌并位于联合肌腱外侧。该入口与肌皮神经之间的距离为22.9±4.9毫米（平均值±标准差），与腋神经之间的距离为24.4±5.7毫米。先前描述的入口位于3点钟位置或其上方，导致进入肩胛盂颈部的角度陡峭且困难。通过适当的手臂定位和杆插入技术相结合，5点钟入口可以安全创建，并且在关节镜下肩部稳定手术中具有很大的潜在实用价值。
