关节镜下喙突移位术:手术技术与早期随访探讨  

Arthroscopic Latarjet Procedure:Surgical Technique and Early Follow-up Results

作　　者：姜春岩[1] 吴关[1] 鲁谊[1] 朱以明[1] 李奉龙[1] 刘心[1] 

机构地区：[1]北京积水潭医院运动损伤科,北京100035

出　　处：《中国运动医学杂志》2014年第4期297-302,311,共7页Chinese Journal of Sports Medicine

基　　金：北京市卫生局"215"优秀人才培养计划项目

摘　　要：目的：探讨关节镜下喙突移位术（Latarjet手术）的技术特点及早期临床结果。方法：2012年11月至2013年3月共有18例肩关节前向不稳定患者行全关节镜下Latarjet手术．所有患者均获得6个月以上随访，对比患者术前及随访时的肩关节活动度（包括前屈上举FE、外旋ER）及Rowe评分，并通过术后CT评价骨移植物位置优劣。结果：所有患者于术后平均6．5个月进行随访，未发现复发脱位及半脱位。术前Rowe评分平均43．6分（25～50分）；术前FE平均176．7°（160°～180°），ER平均65．6°（45°～90°）。术后6个月Rowe评分平均74．4分（60～95分）；术后FE平均163．3°（150°～180°）。ER平均41．1°（30°-60°）。术后CT显示，骨块与肩盂平齐的为77．8％，外凸11．1％，偏内侧11．1％。骨块位于2点～5点位置的占83．3％，过高11．1％，过低5．6％。结论：关节镜下Latarjet手术的初步临床随访结果显示。患者活动及功能恢复满意。通过合理的手术技术操作，喙突骨块可达到良好的位置。Objective To present the surgical technique and short-term follow up results of the arthroscopic Latarjet procedure. Methods From November 2012 to March 2013,18 Latarjet procedures were performed arthroscopically for patients with anterior shoulder instability. All patients were available for a minimum of 6 months follow up. The range of motion （ROM）including flexion elevation （FE）, external rotation （ER）and Rowe score were recorded and compared before the surgery and at the last follow-up. Coracoid graft position was evaluated using CT scanning. Results The average follow-up duration was 6.5 months. There were no cases of recurrent dislocation or subluxation. The mean Rowe score was 43.6 （25-50）before and 74.4 （60-95）after surgery. ROM before and after surgery showed an average FE of 176.7° （ 160°-180°）and 63.3° （ 150°-180° ）, and average ER of 65.6° （45°-90° ）and 41.1° （30°-60°）. According to the CT scanning at the final follow up,the graft was flush with the glenoid in 77.8%,medially placed in 11.1%, and laterally placed in 11.1%. Vertical positioning was perfect in 83.3%（2 to 5 o＇clock）,too high in 11.1%,and too low in 5.6%. Conclusion Arthroscopic Latarjet technique shows satisfactory results at the early stage after surgery with minimal complications and good graft positioning.

关 键 词：肩关节 不稳定 关节镜 喙突移位 

分 类 号：R873[医药卫生—运动医学]