Field L D, Bokor D J, Savoie F H
Upper Extremity Service, Mississippi Sports Medicine and Orthopaedic Center, Jackson 39202, USA.
J Shoulder Elbow Surg. 1997 Jan-Feb;6(1):6-10. doi: 10.1016/s1058-2746(97)90064-1.
Recurrent anterior unidirectional shoulder instability is most commonly associated with an avulsion of the glenoid attachment of the labroligamentous complex (Bankart lesion). However, additional capsular injury is often considered necessary to allow anterior dislocation. Five patients undergoing surgical stabilization for recurrent anterior instability were noted to have not only a classic Bankart lesion but also a complete disruption of the lateral capsule from the humeral neck. Repair of this "floating" anterior inferior glenohumeral ligament was accomplished by reattachment of the medial and lateral capsular disruptions and has led to excellent postoperative function in these patients. None of the patients has had instability after an average follow-up of 26 months. Identification and repair of this unusual anatomic lesion is important and if missed may have a significant negative effect on postoperative stability.
复发性前向单向肩关节不稳最常与盂唇韧带复合体的盂附着处撕脱（Bankart损伤）相关。然而，通常认为还需要额外的关节囊损伤才会导致前脱位。5例因复发性前向不稳接受手术稳定治疗的患者不仅存在典型的Bankart损伤，而且肱骨头颈外侧关节囊完全断裂。通过重新附着内侧和外侧关节囊断裂处来修复这种“浮动”的肩胛下肌下盂肱韧带，术后这些患者功能良好。平均随访26个月后，所有患者均未出现不稳情况。识别并修复这种不寻常的解剖学损伤很重要，若遗漏可能会对术后稳定性产生重大负面影响。
