关节镜治疗肩关节前脱位的术式选择  

Surgical options in arthroscopic surgery for anterior dislocation of shoulder

作　　者：杨杰 杨砥[1] 刘炯[1] 陈春[1] 肖坤[1] 吴凯峰 

机构地区：[1]贵阳市第四人民医院骨科,贵州贵阳550002

出　　处：《中国矫形外科杂志》2017年第22期2080-2085,共6页Orthopedic Journal of China

摘　　要：[目的]探讨分析关节镜治疗肩关节前脱位的术式选择。[方法]收集本院2015年1月~2017年2月收治的12例肩关节前脱位合并Bankart损伤、Hill-Sachs损伤的病例,参照肩关节"肩胛盂轨迹"(On Track/Off Track)概念的术式推荐选择合适的手术方式行关节镜手术治疗患者的临床资料,进行回顾性分析。[结果]所有患者获得5~31个月随访,平均(17.17±8.92)个月。Rowe评分由术前的平均(32.92±7.75)分提高为末次随访时的(89.42±4.44)分,末次随访Rowe评分显著高于术前,差异有统计学意义(t=-19.546,P<0.001)。ASES评分由术前的(72.42±5.99)分提高至末次随访时的(91.50±4.12)分。末次随访ASES评分显著高于术前,差异有统计学意义(t=-12.597,P<0.001)。所有随访患者均无肩关节前脱位复发,恐惧试验全部阴性,术后患者均恢复日常生活、工作及学习。[结论]参照"肩胛盂轨迹"概念进行肩关节前脱位术前评估,分析肩胛盂及肱骨头后外侧骨性缺损大小,通过获得有效的数据,推荐合适的手术方式,取得良好效果。[Objective] To discuss the selection of procedure in arthroscopic surgery with anterior dislocation of shouhter. [Methods] Twelve patients with anterior dislocation of shouhler, combined with the Bankart Lesion or Hill-Sachs Lesion were collected from January 2015 to February 2017 at the fourth People＇s Hospital of Guiyang. The ＂Glenoid Track＂ concept was used to choose the suitable procedure for arthroscopic treatment. [Results] The follow-up period ranged from 5 tO 31 months （ mean 17.1±8.9 ）. The Rowe scores increased from （ 32.9±7.8 ） to （ 89.4±4.4 ）（ t=-19.5, P 〈 0.05 ）, the ASES scores increased from （ 72.4±6.0 ） to （ 91.5±4.1 ）（ t=-12.6, P 〈 0.05 ）. No case recurrenced of shoulder dislocation, and apprehension test rcsuhs were negative. All patients regained normal daily life, work land study. [Conclusion] Application of glenoid track concept for anterior shouhter instability evaluation, and analysis of bone loss degrees of the glenoid and the proximal humerus are helpful to obtain effective information to apply suitalbe sugical procedure and acquire satisfactory outcomes.

关 键 词：肩关节前脱位 关节镜 BANKART HILL-SACHS 肩胛盂轨迹 

分 类 号：R687.4[医药卫生—骨科学]