反復性肩関節前方脱臼に対する肩甲下筋(腱)を利用した鏡視下 multiple suture 法(Caspari 法) Arthroscopic Transglenoid Multiple Suture (Caspari) Technique using Subscapularis for Recurrent Anterior Dislocation of the Shoulder

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[Purpose]Caspari's transglenoid multiple suture technique is an arthroscopic Bankart repair with sufficient capsular shift, but recurrence is high for the patients with a defective middle/inferior glenohumeral ligament structures. We tried the Caspari technique using the subscapularis muscle to increase the buttress effect of the anterior capsular mechanism.<BR>[Material and Methods]We retrospectively studied 26 patients with recurrent anterior dislocation of the shoulder. The average age at operation was 24 years. The average postoperative follow-up period was 26 months. In addition to the conventional Caspari technique, we abraded medially to the base of the anterior glenoid neck and placed nonabsorbable sutures into the superior portion of subscapularis tendon. In the arthroscopic finding, anterior inferior glenohumeral ligament was poor quality in 17shoulders, thin or narrow and thin/narrow in 15. Defect of the glenoid was in 11, and a bony Bankart lesion was in 9. Middle glenohumeral ligament was cord-like or membranous in 13, and the inferior foramen in 19.<BR>[Results]No recurrence was observed postoperatively. According to Rowe's scale, the clinical outcome was excellent in 18 patients, good in 8. The average limitation of external rotation was 13.6 degrees with the arm at the side and 4.3 degrees with the arm in 90 degrees of abduction.<BR>[Conclusion]Caspari technique using the subscapularis muscle was useful for those patients who could not be expected to achieve the anterior buttress effect by a conventional arthroscopic Bankart procedure.

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  • 肩関節 = Shoulder joint

    肩関節 = Shoulder joint 23(2), 343-347, 1999-07-30

    Japan Shoulder Society

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