Surgical anatomical landmarks for arthroscopic repair of subscapularis tendon tears.

IF 1.8 Q2 ORTHOPEDICS Clinics in Shoulder and Elbow Pub Date : 2024-09-01 Epub Date: 2024-05-08 DOI:10.5397/cise.2023.01165
Santiago Gabardo, María Valencia-Mora, Ismael Coifman, Emilio Calvo
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Abstract

Background: Subscapularis repair has recently garnered significant interest. A thorough understanding of the tendon's anatomy is essential for precise and safe repair. Our objectives were to describe the anatomy of the subscapularis insertion, define its landmarks, and analyze nearby structures to guide arthroscopic repair.

Methods: We conducted an anatomical study, dissecting 12 shoulders. We evaluated the distance from the footprint to the axillary nerve, the dimensions, and shape of the footprint, and its relationship with the humeral cartilage.

Results: The distance to the axillary nerve was 32 mm (standard deviation [SD], 3.7 mm). The craniocaudal length of the footprint was 37.3 mm (SD, 4.6 mm). Its largest mediolateral thickness was 16 mm (SD, 2.2 mm), wider at the top and narrower distally. The distance between the footprint and the cartilage varied, being 3.2 mm (SD, 1.2 mm) in the upper part, 5.4 mm (SD, 1.8 mm) in the medium, and 15.9 mm (SD, 2.9 mm) in the lower part.

Conclusions: When performing a repair of the subscapularis tendon, the distance to the cartilage should be carefully evaluated as it varies proximally to distally, and the shape of the footprint (wider proximally, tapered distally) should be considered for implant positioning. The distance to the axillary nerve is approximately 30 mm. Anterior visualization guarantees direct control of all landmarks and allows accurate implant positioning with safe tendon release. Level of evidence: IV.

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肩胛下肌腱撕裂的关节镜修复手术解剖标志。
背景:肩胛下肌腱修复术近来备受关注。透彻了解肌腱的解剖结构对于精确、安全的修复至关重要。我们的目标是描述肩胛下肌腱插入处的解剖结构,确定其标志物,并分析附近结构以指导关节镜修复:我们对 12 个肩部进行了解剖研究。我们评估了足底到腋神经的距离、足底的尺寸和形状以及与肱骨软骨的关系:结果:脚印到腋神经的距离为32毫米(标准差[SD],3.7毫米)。足弓的头尾长度为37.3毫米(标准差为4.6毫米)。其最大内外侧厚度为 16 毫米(标准差为 2.2 毫米),顶部较宽,远端较窄。足底与软骨之间的距离各不相同,上部为 3.2 毫米(标度为 1.2 毫米),中部为 5.4 毫米(标度为 1.8 毫米),下部为 15.9 毫米(标度为 2.9 毫米):在对肩胛下肌腱进行修复时,应仔细评估与软骨的距离,因为其从近端到远端各不相同,而且在进行植入物定位时应考虑足迹的形状(近端较宽,远端较细)。与腋神经的距离约为 30 毫米。前方视野可确保直接控制所有地标,并在安全松解肌腱的情况下准确定位植入物。
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来源期刊
CiteScore
0.30
自引率
0.00%
发文量
55
审稿时长
15 weeks
期刊最新文献
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