Publication: Estudio anatómico comparativo de la técnica de Latarjet abierta y artroscópica para el tratamiento del hombro inestable
Loading...
Official URL
Full text at PDC
Publication Date
2018-11-26
Authors
Advisors (or tutors)
García Esteo, Francisco Javier
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
La inestabilidad de hombro es un problema frecuente, con una incidencia de 24 casos por cada 100.000 habitantes. Este problema ha recibido diferentes soluciones quirúrgicas a lo largo del tiempo; una de ellas, ha sido la utilización de un fragmento óseo, colocado en el borde anteroinferior de la glenoides para impedir la traslación anterior de la cabeza. De entre estas técnicas, la técnica descrita por Latarjet, en 1954, ha sido ampliamente utilizada.El mecanismo el funcionamiento de la técnica de Latarjet, fue perfectamente descrita por Patte, y se basa en el denominado ” triple efecto de bloqueo”. En primer lugar, la apófisis coracoides transferida, aumenta la superficie anterior inferior de la glenoides (bloqueo óseo).En segundo lugar, la transferencia del tendón conjunto con la apófisis ósea a través de una apertura del tendón el músculo subescapular, crea un efecto de sujeción dinámica, que previene el desplazamiento anterior de la cabeza humeral (Bloqueo músculo tendinoso). Por último,la reparación de la cápsula articular y su sutura al muñón de ligamento coracoacromial,produce un efecto de retensado de la cápsula inferior (bloqueo cápsular)...
Shoulder instability is a frequent problem, with an incidence of 24cases per 100,000 inhabitants. This problem has received different surgical solutionsover time; one of them, was the use of a bone fragment placed at the anterior-inferioredge of the glenoid to prevent anterior translation of the head. The technique described byLatarjet in 1954 is one of them and it has been widely used. The biomechanics of the Latarjettechnique was perfectly described by Patte, and is based on the so-called “triple blockingeffect”. First, the transferred apophysis of the coracoid process increases the lower anteriorsurface of the glenoid (bone block). Second, the transfer of the conjoint tendon to the boneprocess through a split of the tendon the subscapularis muscle, creates a dynamic clampingeffect, which prevents the anterior displacement of the humeral head (musculoskeletalblock). Finally, the repair of the joint capsule and its suture to the coracoacromialligament stump, produces a retensioning effect of the lower capsule (capsular block).Recently, some authors have developed an arthroscopic method for performing thistechnique. In the early procedures, the use of arthroscopy was only a visual aid for placingthe graft in the right position. In 2007, Lafosse described a completely arthroscopic techniquefor the transfer of the coracoid apophysis to the anterior inferior part of the glenoid neck,faithfully reproducing the technique described by Latarjet 50 years before...
Shoulder instability is a frequent problem, with an incidence of 24cases per 100,000 inhabitants. This problem has received different surgical solutionsover time; one of them, was the use of a bone fragment placed at the anterior-inferioredge of the glenoid to prevent anterior translation of the head. The technique described byLatarjet in 1954 is one of them and it has been widely used. The biomechanics of the Latarjettechnique was perfectly described by Patte, and is based on the so-called “triple blockingeffect”. First, the transferred apophysis of the coracoid process increases the lower anteriorsurface of the glenoid (bone block). Second, the transfer of the conjoint tendon to the boneprocess through a split of the tendon the subscapularis muscle, creates a dynamic clampingeffect, which prevents the anterior displacement of the humeral head (musculoskeletalblock). Finally, the repair of the joint capsule and its suture to the coracoacromialligament stump, produces a retensioning effect of the lower capsule (capsular block).Recently, some authors have developed an arthroscopic method for performing thistechnique. In the early procedures, the use of arthroscopy was only a visual aid for placingthe graft in the right position. In 2007, Lafosse described a completely arthroscopic techniquefor the transfer of the coracoid apophysis to the anterior inferior part of the glenoid neck,faithfully reproducing the technique described by Latarjet 50 years before...
Description
Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Anatomía y Embriología Humanas, leída el 02-06-2017