骨移植重建肩关节后脱位合并肱骨头前内侧骨缺损的临床疗效分析  

The clinical outcome of anatomical reconstruction with bone graft for humeral head impression fractures after posterior shoulder dislocation

作　　者：徐德兴[1] 陈昌礼[1] 陈硕[1] 

机构地区：[1]都江堰市医疗中心外四科,四川成都611830

出　　处：《四川医学》2012年第5期818-820,共3页Sichuan Medical Journal

摘　　要：目的自体或异体骨移植方法解剖重建肩关节后脱位伴有前内侧骨缺损,恢复肱骨头关节面形态,为肩关节后脱位的诊治提供一种有效、可靠方法。方法 6例患者纳入本次研究,患者平均年龄46.3(35～65)岁,所有患者肩关节后脱位伴有25%～45%肱骨头关节面前内侧骨缺损,2例患者伴有小结节撕脱性骨折,1例患者小结节联合外科颈骨折。6例患者中5例发生肩关节脱位延迟诊断,延迟诊断时间平均71.2(36～105)d。所有患者均采用自体或异体骨移植来解剖修复肱骨头前内侧骨缺损,恢复肱骨头关节面形态。结果所有患者术后随访16.8(6～30)个月,优秀5例,良好1例,Constant评分平均为84.8(76～90)分,随访时无复发性肩关节脱位、移植骨塌陷以及肩关节不稳表现。结论采用自体/异体骨移植、重建肱骨头形态是一种有效、可靠方法,能够恢复良好肩关节功能及稳定性。Objective There had an anatomical reconstruction with bone autograft/allograft for humeral head impression fractures after posterior shoulder dislocation.It provide a valid and good method for the diagnosis and treatment of posterior shoulder dislocation.Methods Six patients with an average age of 46.3years（35～65）at time of surgery were included.All patients had a 25%～45% anteromedial humeral head articular surface defect associated with five missed locked posterior shoulder dislocation.Two patients had an less tuberosity fracture,one patient had an additional less tuberosity and surgical neck fracture.For five patients the time span between the injury and the diagnosis is 71.2 days,ranged between 36 and 105 days.all patients used an anatomical repair with bone autograft/allograft for humeral head impression fractures after posterior shoulder dislocation.Results At a mean time follow-up of 16.8 months（6 to 30）,the result was found to be excellent for five patients and good for one patient with a mean Constant Score of 84.8.points（range 76～90）.At the last follow-up no redislocation、graft collapse or instability of the shoulder was seen.Conclusion The proposed method of anatomical head reconstruction by bone auto/allograft proved to be a valid and good method to restore shoulder function and stability.

关 键 词：肩关节后脱位骨折 反Hill-sachs损伤 自体/异体骨移植 解剖重建 

分 类 号：R687.4[医药卫生—骨科学]