Superior clavicle drilling points and fluoroscopic inclination for anatomic coracoclavicular ligament reconstruction: a cadaveric study.
Superior clavicle drilling points and fluoroscopic inclination for anatomic coracoclavicular ligament reconstruction: a cadaveric study.
复制标题
用于解剖喙锁韧带重建的锁骨上钻孔点和透视倾斜度：尸体研究。
DOI：
10.1007/s00167-019-05539-7
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发表时间：
2019
影响因子：
3.8
通讯作者：
Lin A.
中科院分区：
文献类型：
--
作者：
Takenaga T;Yoshida M;Debski RE;Fu FH;Musahl V;Lin A.
目的探讨喙锁韧带重建术中锁骨上上级皮质钻孔点和X线透视下解剖隧道钻孔的倾斜角度。插入2根2.0 mm克氏针，穿过锁骨和喙突上圆锥形和梯形的足迹中心。测量克氏针在上级锁骨皮质上的位置。X线透视用于获得肩关节的三个视图：前后位、侧位和皮质环征视图。结果克氏针穿过圆锥体的位置距锁骨远端40. 0 ± 3. 9mm，距锁骨前缘18. 1 ± 3. 0mm。对于梯形，克氏针位于距离远端19.1 ± 3.6 mm和距离前缘9.9 ± 3.9 mm处。在前后位片上，圆锥形与盂肱关节线的夹角为11.1° ± 10.1°，梯形与盂肱关节线的夹角为26.8° ± 11.8°。在侧位片上，圆锥形与肩胛冈的夹角为42.8° ± 15.1°，多角形与肩胛冈的夹角为15.5° ± 12.0°。在皮质环征切面上，圆锥形与肩胛骨的夹角为50.8° ± 12.9°，梯形与肩胛骨的夹角为14.2 °± 11.0°。结论为喙锁韧带重建术提供了锁骨上上级皮质钻孔点和透视下钻孔倾角。关节镜辅助的解剖喙锁韧带重建越来越受欢迎，这些发现可能有助于喙锁韧带重建的解剖方法。
PurposeThis study aims to investigate the superior clavicle cortex drilling points and fluoroscopic inclination angles for anatomic tunnel drilling in coracoclavicular ligament reconstruction.MethodsTwelve cadaveric shoulders with a mean age of 55.9 ± 6.2 years were investigated. Two 2.0 mm Kirschner wires were inserted penetrating the footprint centers of conoid and trapezoid both on the clavicle and coracoid. The location of the Kirschner wires on the superior clavicle cortex was measured. Fluoroscopy was used to obtain three views of shoulder: an anteroposterior, lateral, and cortical ring sign view. Reproducible angles were then recorded.ResultsThe Kirschner wire penetrating the conoid was located 40.0 ± 3.9 mm from the distal end and 18.1 ± 3.0 mm from the anterior edge of the clavicle. For the trapezoid, the Kirschner wire was located 19.1 ± 3.6 mm from the distal end and 9.9 ± 3.9 mm from the anterior edge. On the anteroposterior view, the conoid was 11.1° ± 10.1° medially and trapezoid was 26.8° ± 11.8° laterally tilted to the glenohumeral joint line. On the lateral view, the conoid was 42.8° ± 15.1° and trapezoid was 15.5° ± 12.0° superiorly tilted to the scapular spine. On the cortical ring sign view, the conoid was 50.8° ± 12.9° and trapezoid was 14.2 °± 11.0° superiorly tilted to the scapular spine.ConclusionsThe superior clavicle cortex drilling points and fluoroscopic inclination angles for anatomic tunnel drilling in coracoclavicular ligament reconstruction were demonstrated. Arthroscopy-assisted anatomic coracoclavicular ligament reconstruction has increased in popularity, and these findings may facilitate a more anatomic approach to coracoclavicular ligament reconstruction.