肩关节前下盂唇损伤非牵引下关节镜修复术的临床分析  

Application of arthroscopic repair without traction for non-osseous Bankart injury in shoulder

作　　者：刘欣伟[1] 刘松波[1] 丁国成 刘铭[1] 郭超[1] 张敬东[1] 王宇[1] LIU Xin-wei;LIU Song-bo;DING Guo-cheng;LIU Ming;GUO Chao;ZHANG Jing-dong;WANG Yu(De partme nt of Ortho-pedic ,Laboratory of Severe Wound and Trauma of Chinese PLA,General Hospital of Shenyang Military Area Commond,110016, China)

机构地区：[1]宇(沈阳军区总医院骨科、全军重症战创伤救治中心,辽宁沈阳110016

出　　处：《局解手术学杂志》2017年第11期799-802,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：辽宁省自然科学基金(20170540942)

摘　　要：目的探讨非牵引技术在肩关节前下盂唇损伤肩关节镜修复术中的应用效果。方法回顾性分析2009年1月至2015年1月我科收治的182例肩关节前下盂唇损伤患者的临床资料,年龄18~39岁,平均(26.5±9.3)岁;病程1~10年,平均(3.2±2.6)年;复发脱位6~62次,平均(24.2±17.3)次。在非牵引技术下进行了侧卧位肩关节镜下非骨性修复术,术后采用Rowes评分、UCLA评分系统进行疗效评价。结果 182例获6~18个月随访,平均(12.5±6.7)个月。12例术后外旋活动受限20°,无法参加对抗性训练,余170例能够参加对抗性训练。全部患者平均肩关节外旋活动角度丢失(10.5±4.1)°。术后UCLA评分(89±3.5)分较术前(25±6.2)分明显提高,差异具有统计学意义(P<0.05);术后Rowes评分(28.7±2.2)分较术前(7.3±1.6)分明显提高,差异具有统计学意义(P<0.05)。结论非牵引技术在训练伤致肩关节前下盂唇损伤肩关节镜修复术中的应用疗效满意,术中因无巨大的外力牵引从而保护了臂丛神经、血管等组织,有利于患者快速康复,值得在基层医院推广应用。Objective To explore the clinical effect of arthroscopic repair without traction for non-osseous Bankart injury. MetliodsFrom January 2009 to January 2015,the clinical data of 182 cases underwent arthroscopic Bankart repair for anterior shoulder instability inour hospital were analyzed retrospectively. They were aged froml8 to 39 years old,mean age was（26. 5 ± 9was from1 to 10 years,mean duration was（3. 2 ±2. 6） years. Recurrent dislocation was 6 to 62 times,with average of （24.2 ±17.3） times. A1 cases were performed arthroscopic repair without traction. Rowes scores and UCLA scores were used for evaluation. Results All of 182 cases were followed up from6 to 18 months, an average of （（2. 5 ±6.7）months. Of the 182 patients, 12 cases with postoperative limited 2 0°external rotation could not attend confrontational training and the other 170 cases had no adverse effect. The average loss of shoulder joint ex-torsion activity angle were （10.5 ±4. 1）°. Postoperative UCLA score （89 ±3.5） was more than preoperative （25 ±6.2） , the differences were significant^ P 〈0. 05 ）. Postoperative Rowes score（28. 7 ± 2. 2） were more than preoperative（7. 3 ± 1.6）,the differences were signifi-cant/3 〈0. 05） . Conclusion Curative effect of arthroscopic repair without traction for non-osseous Bankart injury caused by training is sati- factory,which can provide brachial plexus,blood vessel and other tissues during surgery from traction, and be helpful to the popularization and application in basic-level hospitals.

关 键 词：BANKART损伤 关节镜 肩关节不稳 盂肱关节 

分 类 号：R687.3[医药卫生—骨科学]