Editorial Commentary: Why We Have To Respect The Anatomy In Acromioclavicular Joint Surgery And W...

Over the past decade, the interest in acromioclavicular (AC) joint research has experienced a revolutionary increase.

图片发自App

图片发自App

Biomechanical and anatomic studies have been carried out to investigate and obtain a better understanding of the function of this joint. The reason for this huge investigational effort is the fact that we do not have any gold standard for the treatment, diagnosis, or follow-up of patients with acute or chronic AC joint injuries.

（需要进一步明确AC关节损伤的分类；印象中是对肩锁关节半脱位的分类）

This is reflected by the huge number of over 160 different surgical techniques described in the literature.

160种手术方法确实是百花齐放！

So far, we have a variety of anatomic procedures, nonanatomic procedures, and nonanatomic procedures with open reduction and internal fixation, with a significantly better clinical outcome for anatomic techniques. Because of this wide variety, it is hard and nearly impossible to compare clinical data.

也就是说综述对于这一块可能是个盲区，可以有时间的时候查阅一下文献。

Within the past 5 years, we have focused not only on the vertical instability but also, more and more, on the horizontal instability and tried to understand the rotational component of this joint with the importance of scapulothoracic motion.

除了垂直移位，需要将更多的关注点放在水平移位以及肩胛胸壁活动中参与肩关节旋转的相关结构。

The evolutionary advantage of bipedalism with the support of the clavicle compared with quadrupedalism allows us to lift our arms for overhead activities.

（锁骨的价值是在直立行走时，方便肩膀能举过头顶！OMG！锁骨的作用？？）

Therefore, we need an intact sternoclavicular and AC force transfer, described as the "strut function," to give a resistance against the thorax when abducting the arm over 90°.

锁骨是力量的传导，直到胸锁关节，传至胸部。

Once we have an interruption in this force transfer, we believe that it is the most important aspect in AC joint surgery to try to anatomically restore this joint's anatomy.

出于此原因，恢复解剖结构对于肩关节外展90度及以上的力量传导非常有意义。

For this reason, we have changed our practice in the past few years in line with the newly derived data, by addressing the coracoclavicular ligaments as well as the AC capsule to restore horizontal and vertical stability but also allow for physiological rotation and movement.

Addressing=think about and begin to do Sth.

手术要求重建喙锁韧带和肩锁关节囊。