Le Huec J C, Zipoli B, Schaeverbeke T, Moinard M, Chauveaux D, Le Rebeller A
Service d'Orthopédie, CHU de Bordeaux, France.
Acta Orthop Belg. 1996 Jun;62(2):107-12.
A chronic cyst of the acromioclavicular joint was treated in 3 patients who were followed up for an average period of 26 months. All three were over 60 years old and presented with a massive rupture of the rotator cuff with a subnormal range of passive motion; active motion was variably affected and was painful. The patients underwent resection of one cm of the lateral end of the clavicle, together with resection of the cyst and synovectomy of the upper part of the pathologic humero-acromial joint; the coraco-acromial ligament was left in place. With a mean follow-up of 26 months, the 3 patients have significant pain relief and no cyst has recurred. The authors propose a mechanism to explain the persistence of the cysts in patients with massive rotator cuff tear: elevation of the arm brings the humeral head upwards and forces synovial fluid into the acromioclavicular joint through a perforation in the frayed capsule; this communication is later obstructed by synovial fringes which prevent drainage of the fluid. Excision of the synovium cures the problem.
对3例肩锁关节慢性囊肿患者进行了治疗，并对其进行了平均26个月的随访。所有3例患者均年龄超过60岁，表现为肩袖巨大撕裂，被动活动范围低于正常；主动活动受到不同程度影响且疼痛。患者接受了锁骨外侧端1厘米切除术，同时切除囊肿并对病理性肱肩峰关节上部进行滑膜切除术；喙肩韧带保留原位。平均随访26个月时，3例患者疼痛明显缓解，无囊肿复发。作者提出了一种机制来解释巨大肩袖撕裂患者囊肿持续存在的原因：手臂抬高使肱骨头向上，迫使滑液通过磨损关节囊的穿孔进入肩锁关节；这种连通随后被滑膜皱襞阻塞，阻止了液体引流。切除滑膜可解决该问题。
