New endoscopic classification for subscapularis lesions

Toussaint, B.; Barth, Johannes; Charousset, Christophe; Godenèche, Arnaud; Joudet, Thierry; Lefèbvre, Yves; Nové-Josserand, Laurent; Petroff, E.; Solignac, N.; Hardy, P.; Scymanski, Christophe; Maynou, C.; Thélu, Charles-Édouard; Boileau, Pascal; Graveleau, Nicolas; Audebert, Stéphane

doi:10.1016/j.otsr.2012.10.003

Cited by 41 publications

(43 citation statements)

References 25 publications

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“…Esta clasificación da pistas claras sobre la naturaleza de la rotura y ayuda en la toma de decisiones durante la cirugía. Las roturas subescapulares tienen un comportamiento diferente a las posterosuperiores y son clasificadas de manera distinta (tabla 1) 20 .…”

Section: Patrones De Rotura Y Clasificaciónunclassified

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Reparación artroscópica de las roturas del manguito rotador

Ibán

Expósito

Heredia

et al. 2014

Revista Española de Artroscopia y Cirugía Articular

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Cómo citar este artículo: Ruiz Ibán MÁ, et al. Reparación artroscópica de las roturas del manguito rotador. Rev Esp Artrosc Cir Articul. 2015. http://dx.información del artículo Historia del artículo: Recibido el 20 de octubre de 2014 Aceptado el 16 de diciembre de 2014 On-line el xxx Palabras clave: Manguito rotador Reparación Artroscopia r e s u m e n La reparación artroscópica de los trastornos del manguito rotador es un procedimiento téc-nicamente exigente pero exitoso. Las claves para un buen resultado son la combinación de una indicación adecuada, una buena técnica y un estricto protocolo de rehabilitación. El manejo terapéutico de las lesiones debe ser evaluado teniendo en cuenta las consideraciones personales, anatómicas y biológicas.Durante el procedimiento artroscópico el primer paso es identificar el patrón de la lesión y definir la estrategia para su reparación. Tras esto el cirujano debe preparar la huella de la inserción del manguito y usar una técnica de reparación que mejore el contacto tendón-hueso. Es fundamental conseguir una reparación libre de tensión, con liberaciones de tendón si fuese necesario.En el postoperatorio es esencial un protocolo que proteja la reparación tendinosa y a su vez evite la rigidez. a b s t r a c tArthroscopic repair of rotator cuff disorders is a technically demanding, but successful procedure. The main keys to success are a combination of proper indication, good technique, and an adequate rehabilitation protocol. The tears should be evaluated for reparability, taking into account personal, anatomical, and biological considerations. * Autor para correspondencia.Correo electrónico: drmri@hotmail.com (M.Á. Ruiz Ibán). http://dx.

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Section: Patrones De Rotura Y Clasificaciónunclassified

“…Rotura completa, las fibras superficiales en continuidad con la polea del bíceps Rota en continuidad con el tendón Tipo 4 Rotura completa, borde libre Rota y sin continuidad con el tendón De Toussaint et al 20 .…”

Section: Tabla 1 -Clasificación De Toussaint Para Roturas Del Tendón unclassified

Reparación artroscópica de las roturas del manguito rotador

Ibán

Expósito

Heredia

et al. 2014

Revista Española de Artroscopia y Cirugía Articular

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“…There are significant differences between the anatomical characteristics of the subscapularis tendon compared to the supraspinatus and the infraspinatus tendons [1]. From an anatomical point of view the subscapularis can be divided into several parts.…”

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confidence: 99%

“…The superior and middle parts have deep fibres which insert on the lesser tuberosity and the floor of the bicipital groove and superficial fibres traversing over the biceps to insert on the greater tuberosity [5]. The inferior part consists of muscle fibres attaching directly to the distal lesser tuberosity on a narrow vertical footprint [1].…”

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confidence: 99%

The Challenges of Arthroscopic Diagnosis of Subscapularis Tears

Haritinian¹,

Sendrea²,

Josserand³

2018

Rev. Chim.

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Visualisation of subscapularis lesions is difficult during open surgery. Introduction of arthroscopic procedures for rotator cuff surgery improved the diagnosis of subscapularis tears, but it still can be more challenging than for other rotator cuff tendon tears. The SFA classification of subscapularis tears is reproducible and correlates well with the arthroscopic findings. The arthroscopic diagnosis of subscapularis tear is made easier by: shoulder internal rotation, biceps tenodesis, dissection of the rotator interval, recognition of the sentinel and comma signs.

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“…This arthroscopic finding has since become accepted orthopaedic nomenclature pathognomonic for subscapularis tears and a key component of subscapularis tear classification. 2,3 We propose an alternative theory of the pathoanatomy of the comma sign in anterosuperior rotator cuff tears and present the technique of comma signedirected repairs of combined subscapularis and supraspinatus lesions.…”

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confidence: 99%

Comma Sign–Directed Repair of Anterosuperior Rotator Cuff Tears

Dilisio

Neyton

2014

Arthroscopy Techniques

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The comma sign was described as an arthroscopic landmark to identify the torn subscapularis stump to mobilize and repair the tendon in anterosuperior rotator cuff tears. It was hypothesized that it is composed of the humeral attachments of the superior glenohumeral and coracohumeral ligaments. This arthroscopic finding has since become accepted orthopaedic nomenclature pathognomonic for subscapularis tears and a key component of subscapularis tear classification. We propose an alternative theory of the pathoanatomy of the comma sign in anterosuperior rotator cuff tears and present the technique of comma signedirected repairs of combined subscapularis and supraspinatus lesions. After appropriate releases, tendon-to-tendon repair of the distal-superior aspect of the comma sign to the upper border of the remnant subscapularis results in anatomic re-creation of the intra-articular portion of the torn subscapularis with concomitant reduction of the anterior leading edge of the supraspinatus and reconstitution of the rotator cable complex. A tension-free, single-anchor subscapularis repair is then performed to secure the tendon to the lesser tuberosity. After subscapularis repair, the supraspinatus that was previously retracted to the glenoid rim takes the appearance of a crescenttype tear that is easily approximated to its anatomic insertion.

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New endoscopic classification for subscapularis lesions

Cited by 41 publications

References 25 publications

Reparación artroscópica de las roturas del manguito rotador

Reparación artroscópica de las roturas del manguito rotador

The Challenges of Arthroscopic Diagnosis of Subscapularis Tears

Comma Sign–Directed Repair of Anterosuperior Rotator Cuff Tears

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