METHODS: In this anatomical study, an open Trillat Procedure was performed on ten shoulders specimens. The coracoid was fixed by a screw after partial osteotomy and antero-posterior drilling of the scapular neck. The SSN was dissected with identification of the screw. We measured the distances SSN-screw (distance 1) and SSN-glenoid rim (distance 2). In axial plane, we measured the angles between the glenoid plane and the screw (α angle) and between the glenoid plane and the SSN (β angle).
RESULTS: The mean distance SSN-screw was 8.8 mm +/-5.4 (0-15). Mean α angle was 11°+/-2.4 (8-15). Mean β angle was 22°+/-6.7 (12-30). No macroscopic lesion of the SSN was recorded but in 20% (2 cases), the screw was in contact with the nerve. In both cases, the β angle was measured at 12°.
CONCLUSIONS: During the open Trillat Procedure, the SSN can be injured due to its anatomical location. Placement of the screw should be within 10° of the glenoid plane to minimize the risk of SSN injury and could require the use of a specific guide or arthroscopic-assisted surgery.
方法:在这项解剖学研究中,在十个肩膀标本上进行了开放式Trillat程序。在部分截骨和肩胛骨颈前后钻孔后,用螺钉固定喙突。用螺钉的标识解剖SSN。我们测量了SSN-螺钉(距离1)和SSN-关节盂边缘(距离2)的距离。在轴向平面中,我们测量了关节盂平面与螺钉之间的角度(α角)以及关节盂平面与SSN之间的角度(β角)。
结果:SSN螺钉的平均距离为8.8mm/-5.4(0-15)。平均α角为11°+/-2.4(8-15)。平均β角为22°+/-6.7(12-30)。没有记录到SSN的宏观病变,但在20%(2例),螺钉与神经接触。在这两种情况下,β角测量为12°。
结论:在开放式Trillat程序中,SSN可能由于其解剖位置而受伤。螺钉的放置应在关节盂平面的10°范围内,以最大程度地减少SSN损伤的风险,并且可能需要使用特定的指南或关节镜辅助手术。