关节镜下采用可吸收锚钉前后入路治疗Snyder Ⅱ型肩关节上盂唇前后部损伤  

ARTHROSCOPIC TREATMENT OF SNYDER II TYPE OF SUPERIOR LABRUM ANTERIOR AND POSTERIOR INJURY BY ABSORBABLE ANCHORS THROUGH ANTERIOR AND POSTERIOR APPROACH

作　　者：袁锋[1] 蔡俊丰[1] 周炜[1] 马敏[1] 武强[1] 罗树林[1] 尹峰[1] 

机构地区：[1]同济大学附属东方医院关节与骨病专科,上海200120

出　　处：《中国修复重建外科杂志》2014年第2期197-200,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：上海市卫生局课题资助项目(2013404);上海市浦东新区科委课题资助项目(PKJ2012-Y62)~~

摘　　要：目的探讨关节镜下采用可吸收锚钉前、后入路治疗SnyderII型肩关节上盂唇前后部（superiorlabrumanteriorandposterior，SLAP）损伤的疗效。方法2010年1月-2012年8月，于关节镜下采用可吸收锚钉前、后入路治疗28例SnyderII型SLAP损伤患者。男15例，女13例；年龄30～45岁，平均36．5岁。左肩12例，右肩16例。均有明确外伤史。病程2周～3年，中位病程13个月。O’Brien试验阳性25例，Speed试验阳性26例。肩关节疼痛视觉模拟评分（VAS）为（7．6±1．4）分；肩关节功能按Constant评分法为（60．2±4．3）分。结果手术均顺利完成，切口I期愈合，无感染、血管神经损伤等并发症发生。患者术后均获随访，随访时间12～36个月，平均24，5个月。患者肩关节绞锁、弹响、不稳症状均消失，关节疼痛均明显好转。术后12个月肩关节功能按Constant评分法为（92．7±4．5）分，与术前比较差异有统计学意义（t=-30．279，P=-0．000）；VAS评分为（1．1±0．9）分，与术前比较差异有统计学意义（t=23．810，P=-0．000）。术后1年MRI检查示，25例SLAP损伤完全愈合；3例可见高信号，但患者疼痛及活动度明显改善。结论关节镜下采用可吸收锚钉前、后入路治疗SLAP损伤具有切口较传统术式少、损伤小、恢复快的优点，是有效手术方法之一。Objective To evaluate the effectiveness of arthroscopic treatment of superior labrum anterior and posterior （SLAP） injury by absorbable anchors through anterior and posterior approach. Methods Between January 2010 and August 2012, 28 patients with Snyder II type of SLAP injury underwent arthroscopic operation by absorbable anchors through anterior and posterior approach. There were 15 males and 13 females, aged from 30 to 45 years （mean, 36.5 years）. The left shoulder was involved in 12 cases and the right shoulder in 16 cases. All patients had a clear history of trauma. The disease duration ranged from 2 weeks to 3 years （median, 13 months）. The results of O＇Brien test and Speed test were positive in 25 cases and 26 cases respectively. Shoulder pain visual analogue scale （VAS） was 7.6 ± 1.4. The Constant score of shoulder joint function was 60.2 ± 4.3. Results Operation was successfully completed, and the incision healed well in all cases, with no complication. The follow-up time ranged from 12 to 36 months （mean, 24.5 months）. The symptoms of shoulder joint interlocking, snapping, and instability disappeared. The joint pain was significantly improved. At 12 months after surgery, Constant score of shoulder joint function was 92.7 ± 4.5, showing significant difference when compared with preoperative score （t=-30.279, P=0.000）; the shoulder pain VAS score was 1.1 ± 0.9, showing significant difference when compared with preoperative score （t=23.810, P=0.000）. At 1 year after operation, MRI examination showed complete healing in 25 cases, and high signal in 3 cases, but the pain and activity were significantly improved. Conclusion Arthroscopic treatment of SLAP injury by absorbable anchors through anterior and posterior approach has the advantages of less injury, small incision, and quick recovery, so it is an ideal operation method.

关 键 词：肩关节上盂唇前后部损伤 关节镜 可吸收锚钉 前后入路 

分 类 号：R687.3[医药卫生—骨科学]