运动员复发性肩关节前脱位的关节镜治疗  

Arthroscopic treatment of the athletic recurrent shoulder anterior dislocations

作　　者：马佳[1] 崔国庆[2] 王健全 肖健 闫辉 杨渝平 刘玉雷 敖英芳 于长隆 

机构地区：[1]望京医院关节镜与运动医学科,北京100700 [2]北京大学运动医学研究所

出　　处：《中华骨科杂志》2009年第6期544-547,共4页Chinese Journal of Orthopaedics

摘　　要：目的 评价关节镜下肩关节前向稳定手术对运动员复发性肩关节前脱位的治疗效果。方法 2001年1月至2006年12月，应用关节镜下肩关节前向稳定手术治疗运动员复发性肩关节前脱位29例，男15例，女14例；年龄15-35岁，平均（20．7±1．4）岁。手术均采用关节镜下盂唇缝合固定术（带线锚钉技术），必要时辅以关节囊折叠缝合术、旋转间隙闭合术或热皱缩术。以脱位复发率、肩关节活动度、恢复运动水平级别及UCLA、Dawson、SST评分系统对术后疗效进行评价。结果 全部病例随访17～66个月，平均30．2个月。4例（13．8％）失败，其中3例（10.3％）脱位复发，1例发生半脱位。24例（82．8％）基本恢复到伤前运动水平（恢复≥90％）。UCLA、Dawson及SST评分与术前比较差异均有统计学意义，优良率82．8％-89．7％。术后患侧前屈、0°外展位及90°外展位外旋活动度较术前增加，与健侧差值的差异均有统计学意义。结论 运动员复发性肩关节前脱位的关节镜下肩关节前向稳定手术的治疗效果良好，术后肩关节功能评分及关节活动度有明显改善，脱位复发率及运动水平的恢复程度与大多数文献报道的切开手术效果相近。Objective To assess the results of arthroscopic anterior shoulder stabilization of athletes with recurrent anterior shoulder dislocations. Methods From Jan. 2001 to Dec. 2006, 29 athletes （15 males and 14 females） suffered recurrent anterior shoulder dislocations underwent arthroscopic anterior shoulder stabilizations. The age of the patients at the time of surgery was from 15 to 35 years （average, 20.7±1.4 years）. The surgical procedure was performed in a consistent manner： arthroscopie suture anchor repair of the displaced labrum, rotator interval closure supplemented with thermal treatment of the capsule when indicated. The clinical results, including the postoperative recurrence rate, range of motion, and the levels of postoperative recovered to preinjury activity levels and the shoulder scores included the UCLA, Dawson and SST, were used to assess outcomes. Results The following up period ranged from 17 months to 66 months （average, 30.2±4.6 months）. Four of 29 athletes （13.8%） experienced failure. Three （10.3%） had recurrent dislocation after the procedure, and the other had subluxation. 24 athletes （82.8%） recovered to preinjury activity levels （≥90% recovery） after operations. UCLA, Dawson and SST scores statistically significantly improved after surgery. The scores rating of good or excellent achieved 80%-90%. The range of motion about forward flexion, external rotation at the side and external rotation at 90° of abduction improved after surgery compared to the contralateral side. Conclusion The arthroscopic stabilizations of athletes with recurrent anterior shoulder dislocations received success in our study. The postoperative shoulder scores and range of motion achieved good improvements. The arthroscopic recurrent rate and the percents of postoperative recovery are similar to those with open surgery.

关 键 词：肩脱位 关节镜检查 运动损伤 

分 类 号：R686[医药卫生—骨科学]