肱骨头ⅰ类缺血性坏死的核心减压治疗

IF 4.5 Q1 EDUCATION & EDUCATIONAL RESEARCH
Andrew P. Wroblewski, Anthony T Machi, D. Klaus, S. Frangiamore
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引用次数: 0

摘要

补充数字内容可在文本中找到。肱骨头缺血性坏死是一种病因多样且预后不明确的诊断。及时诊断和治疗对于防止头部塌陷和避免表面置换或关节置换手术至关重要。成像方式包括标准x线摄影和磁共振成像,根据坏死程度、头部塌陷或伸入关节盂确定诊断和分期。如果患者在保守治疗后仍持续出现症状,且仍处于病程的早期阶段,肱骨头减压是一个合理的选择,因为它已被证明可以减少疾病进展并提供症状缓解。在此,我们报告了一例52岁的女性患者,她在操作和关节镜下粘连溶解后出现粘连性囊炎,现在表现为肱骨头Cruess期缺血性坏死。该技术(补充视频,补充数字内容1,http://links.lww.com/TSES/A36)演示了使用经皮可扩展铰刀对肱骨头进行核心减压和植骨。证据等级:V级(专家意见)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Core Decompression for Class I Avascular Necrosis of Humeral Head
Supplemental Digital Content is available in the text. Avascular necrosis of the humeral head is a diagnosis of multiple etiologies and unclear prognosis. Prompt diagnosis and treatment are essential to prevent head collapse and avoid resurfacing or joint replacement procedures. Imaging modalities including standard radiography and magnetic resonance imaging establish the diagnosis and stage it according to the degree of necrosis, head collapse, or extension into the glenoid. If the patient stays persistently symptomatic despite conservative treatments and is still in the early stages of the disease course, humeral head core decompression is a reasonable option as it has been shown to decrease disease progression and provide symptomatic relief. Here, we present a case of a 52-year-old female with a history of adhesive capsulitis status postmanipulation and arthroscopic lysis of adhesions, now presenting with Cruess Stage I avascular necrosis of the humeral head. This technique (Supplemental Video, Supplemental Digital Content 1, http://links.lww.com/TSES/A36) demonstrates core decompression and grafting of the humeral head using a percutaneous expandable reamer. Level of Evidence: Level V (expert opinion).
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期刊介绍: Published quarterly, Techniques in Shoulder & Elbow Surgery escorts the reader into the operating room and supplies step-by-step details of exciting and advanced techniques. It explains the evolution of and rationale for the procedures, identifies the pitfalls and possible complications, provides invaluable tips for improving surgical results and it is illustrated cover to cover with high-quality intraoperative photographs and drawings, many in full color.
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