创伤性肩关节前不稳定的临床研究  

Clinical study on traumatic anterior instability of shoulder

作　　者：王予彬[1] 王惠芳[1] 董善国 王华东 朱良雁 周宝康 侯树勋[1] 

机构地区：[1]中国人民解放军第三○四医院骨科

出　　处：《中华外科杂志》1998年第10期588-590,共3页Chinese Journal of Surgery

摘　　要：目的探讨创伤性肩关节前不稳定的诊断标准和治疗原则。方法根据４１例创伤性肩关节前不稳定患者发病机制、病程、症状及体征，肩关节Ｘ线片、气碘双重造影ＣＴ，以及基于关节囊、盂唇愈合机制，采用康复治疗和前关节囊修复成形术治疗的经验，提出诊断标准和治疗原则。结果创伤性肩关节前不稳定的诊断标准为：（１）外伤史；（２）肩前侧痛、无力、关节活动受限和肩周肌肉萎缩；（３）前惧痛征和前抽屉试验阳性；（４）Ｘ线片ＨｉｌＳａｃｈｓ骨缺损和气碘双重造影ＣＴ异常。治疗原则：（１）病程３个月内行康复治疗；（２）病程３个月以上、关节囊撕裂、康复治疗无效者，行手术治疗。治疗结果：４１例患者平均随访１６个月，临床效果满意。结论创伤性肩关节前不稳定诊断标准和治疗原则的提出，对提高肩部损伤的治疗水平以及相关理论的临床研究等。Objective To study the clinical diagnosis,conservative and surgical treatment of traumatic anterior instability of the shoulder. Method Based on the experience in diagnosis and treatment of 41 patients, we put forward criteria for diagnosis and treatment of traumatic anterior instability of the shoulder. Result Diagnostic criteria:(1) history of injury to the shoulder; (2) sharp pain in the anterior aspect of the shoulder and weakness and limitation of range of motion of the shoulder;(3)the positive apprehension sign and or anterior drawer test;(4)a Hill Sachs bony lesion on roentgenogram and abnormal double contrast CT.Treatment:(1)rehabilitation program for the patients having symptoms less than 3 months and without anterior capsular rupture;(2)capsular repair and imbrication procedure for the patients having symptoms more than 3 months, or not satisfied to the rehabilitation treatment,or severe anterior capsular rupture on double contrast CT.The results of the treatment were satisfactory with average 16 month follow up. Conclusion The diagnostic criteria and the treatment principles help improve the results of treatment of shoulder injuries, further clinical study is needed for traumatic anterior instability of the shoulder.

关 键 词：肩关节 创伤 关节不稳定 诊断 治疗 

分 类 号：R684.7[医药卫生—骨科学]