Anterior lip of the glenoid and anterior joint capsule repair

Recurrent dislocation of the shoulder joint is a common complication of traumatic shoulder dislocation, which usually occurs within 2 years after the original dislocation. It often causes recurrence of shoulder dislocation when subjected to slight external force. As the dislocation recurs, the joint becomes more and more unstable. The pathological changes of this injury include the rupture of the joint capsule, the defect on the anterior lip of the scapula, and the humeral head. Posterior lateral compression fracture. There is also a non-invasive dislocation, usually the shoulder joint is normal, and the muscle can be dislocated by a slight muscle pull. This dislocation often has anatomical developmental variations. The corresponding surgical methods should be adopted according to different pathological changes in treatment. Treatment of diseases: dislocation of the shoulder joint Indication The anterior scapular anterior lip and anterior joint capsule repair are suitable for the history of repeated dislocation of the shoulder joint, and the anterior dislocation can be confirmed by the shoulder X-ray film when dislocation. The operation is mainly to repair the tear of the joint capsule and the labial cartilage. Surgical procedure Incision and exposure The operation of the subscapularis muscle is performed with Putti-Platt surgery. 2. Exposing the shoulder joint The humerus is externally rotated to expose the subscapularis tendon, and the venous plexus of the lower edge of the tendon is ligated, and the phrenic nerve and the accompanying anterior circumflex artery are not damaged. The two layers are separated by the nasal septum between the subscapularis tendon and the joint capsule. The tissue was bluntly separated, and a thick silk thread was sutured in the medial part of the subscapularis muscle for the intraoperative traction. The subscapularis tendon was cut at a distance of about 0.5 cm from the small nodule of the humerus, and then the scapular leading edge was explored. It can usually be found that the labrum has been torn off, the joint capsule has been separated from the neck of the scapula, about 0.5 cm outside the rim of the iliac crest, and the sac of the switch is about 4 to 5 cm. 3. Repair the joint capsule Use the bone curette to scrape the damaged surface of the anterior lip. Drill 4 holes on the anterior side of the iliac crest with a curved drill or a special dental drill. The shoulder is abducted by 45° and the external rotation is 10°. The free edge of the lateral lobes of the sac is sewn to the 4 small holes of the iliac crest. Then, the inner flap of the joint capsule is overlapped and sutured on the lateral flap. If there is no curved drill or a special dental drill, a small hole can be formed by using a sharp and firm towel clamp to rotate the jaw edge and then rotate a few times. In another method, the lateral flap of the joint capsule can be nailed to the ankle with a stapling nail, and then the subscapularis muscle is sutured. 4. Suture incision Insulate the incision with isotonic saline, completely stop bleeding, and suture the incision in layers.