弹性固定Latarjet手术发展历程与研究进展  

Development and research progress of suture button fixation Latarjet procedure

作　　者：卢奕燊 陆伟[1] LU Yishen;LU Wei(Department of Sports Medicine,the Second People’s Hospital of Shenzhen,the First Affiliated Hospital of Shenzhen University,Shenzhen Guangdong,518025,P.R.China)

机构地区：[1]深圳大学第一附属医院(深圳市第二人民医院)运动医学科,广东深圳518025

出　　处：《中国修复重建外科杂志》2024年第6期635-640,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的综述弹性固定Latarjet手术发展历程及研究进展。方法查阅国内外弹性固定Latarjet手术相关研究文献,对该术式发展历程及相关改良技术进行总结。结果自1954年法国Latarjet教授首次提出Latarjet手术以来,该术式经历了3次关键变革,并逐渐形成了弹性固定Latarjet手术。目前临床应用结果显示弹性固定Latarjet手术治疗复发性肩关节脱位可获得满意疗效,但是仍存在移植骨块与周围组织撞击、手术破坏喙肩弓及胸小肌等解剖结构等不足。为了进一步减少移植骨块撞击带来的并发症、降低盂肱关节接触压力、消除手术对于肩关节原有生理结构的影响,学者们在其基础上提出了使用FiberTape Cerclage的关节镜下弹性固定Latarjet手术、一致弧Latarjet手术合并重建喙肩韧带、喙突有限截骨线袢固定Latarjet手术(LU-tarjet手术)等相关改良技术,临床应用也获得较好疗效。同时,关节镜下改良嵌入式喙突移位手术(Cuistow手术)、特殊关节盂骨移植技术、关节镜自体髂嵴骨移植术等关节盂重建改良技术也具有良好疗效。但是,目前尚缺乏各项技术的远期随访结果以及各项技术之间的对比研究。结论弹性固定Latarjet手术是治疗复发性肩关节脱位的有效术式,有多种改良术式,但尚无公认“金标准”,需要进一步进行临床及基础研究。Objective To review the development and research progress of suture button fixation Latarjet procedure.Methods A comprehensive literature review was conducted to summarize the development and related modified techniques of the suture button fixation Latarjet procedure.Results Since the Latarjet procedure was first introduced by French scholar Latarjet in 1954,it has undergone three key transformations,resulting in suture button fixation Latarjet procedure,which has shown satisfactory outcomes in treatment of recurrent shoulder dislocation.However,there are still drawbacks such as the risk of impingement of the graft on surrounding tissues,and the surgical disruption of anatomical structures like the coracoclavicular ligament and the pectoralis minor muscle.The scholars have proposed several modified techniques based on the suture button fixation Latarjet procedure to further reduce complications from impingement of the graft,to lower the glenohumeral contact pressure,and to eliminate the impact of surgery on the physiological structures of the shoulder joint.The modified techniques include the arthroscopic suture button fixation Latarjet procedure using FiberTape Cerclage,reconstruction of the coracoacromial ligament during congruent-arc Latarjet procedures,and limit unique coracoid osteotomy suture button Latarjet procedure(LU-tarjet procedure).These modified techniques have also shown good clinical outcomes.Additionally,other related modified techniques for reconstruction of the glenoid,such as Chinese unique Inlay Bristow procedure(Cuistow procedure),arthroscopic glenoid bone grafting with soft fixation,and all-arthroscopic modified Eden-Hybinette procedure,have also demonstrated favorable efficacy.However,there is still a lack of long-term follow-up results for these techniques and comparative studies between them.Conclusion Suture button fixation Latarjet procedure is an effective method for the treatment of recurrent shoulder dislocation.There are various techniques,but there is no recognized gold standard,

关 键 词：复发性肩关节脱位 Latarjet手术 弹性固定 改良术式 

分 类 号：R687.3[医药卫生—骨科学]