格伦oid轨道概念:轨道上和偏离轨道-叙述回顾

Q4 Medicine
Antonio Ventura, Claudia Smiraglio, A. Viscomi, S. De Salvatore, B. Bertucci
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引用次数: 0

摘要

肩部不稳定被描述为肩关节上方肱骨头过度活动引起的功能缺陷。各种类型的盂肱部不稳(GI)已被描述,但外伤性前下型是最常见的。累及性和非累及性Hill-Sachs病变(hsl)的差异与骨质流失评估有关。相反,“轨迹内”和“轨迹外”病变之间的新差异与手术技术密切相关。在盂-径概念(GT)出现之前,文献对复发性胃肠道中盂和肱骨骨缺损的具体受累情况评估甚少。磁共振成像(MRI)和关节磁共振成像已被广泛用于识别和表征韧带结构的病变。然而,只有新技术(3特斯拉MRI)才能准确检测高hsl。相反,计算机断层扫描(CT)已被用于量化关节盂骨缺损。GT概念是评估患者前肩不稳的一个有价值的工具。肩部错位可能需要的不仅仅是关节镜下的Bankart,还可能需要复模或骨转移。具体来说,对于复发性不稳定和关节轨迹病变且关节盂骨丢失小于25%的患者,应考虑孤立Bankart修复。对于偏离轨道的病变和小于25%的关节盂骨丢失,应使用复位。关节盂骨缺损超过25%的患者需要进行骨移植手术。这篇叙述性综述的目的是报道胃肠道“顺行”和“偏离”病变的最新发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Glenoid Track Concept: On-Track and Off-Track—A Narrative Review
Shoulder instability is described as a functional deficiency caused by excessive mobility of the humeral head over the glenoid. Various Glenohumeral Instability (GI) types have been described, but the traumatic anteroinferior form is the most frequent. The differences between engaging and non-engaging Hill–Sachs lesions (HSLs) are linked to bone loss assessment. On the contrary, the novel difference between “on-track” and “off-track” lesions is strictly related to surgical techniques. The specific involvement of glenoid and humerus bone defects in recurrent GI was poorly assessed in the literature before the glenoid-track concept (GT). Magnetic Resonance Imaging (MRI) and Arthro-MRI have been widely used to identify and characterize lesions to the ligamentous structures. However, only new technologies (3 Tesla MRI) accurately detect HSLs. On the contrary, Computed Tomography (CT) has been adopted to quantify glenoid bone deficit. The GT concept is a valuable tool for evaluating anterior shoulder instability in patients. Shoulders out of alignment may require more than just an arthroscopic Bankart, and a remplissage or bone transfer may be necessary. Specifically, isolated Bankart repair should be considered in patients with recurrent instability and an on-track lesion with less than 25% glenoid bone loss. In off-track lesions and less than 25% glenoid bone loss, remplissage should be used. Bone transplant surgery is required for patients with a glenoid bone defect of more than 25%. This narrative review aims to report the most updated findings on “on-track” and “off-track” lesions in GI.
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来源期刊
Clinical Osteology
Clinical Osteology Medicine-Endocrinology, Diabetes and Metabolism
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