改良小切口Latarjet术治疗复发性肩关节前脱位  

Modified Mini-open Latarjet Procedure for Recurrent Anterior Shoulder Instability

作　　者：赖俊辉 江涛 黄永铨 陈善创 苏海涛 

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广州中医药大学第二附属医院,广东广州510006

出　　处：《实用骨科杂志》2017年第12期1066-1068,1077,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨改良小切口Latarjet术治疗肩关节复发性前脱位的临床疗效。方法对2012年1月至2014年12月我院收治的14例合并明显肩盂骨缺损的复发性肩关节前脱位行改良小切口Latarjet手术患者病例资料进行回顾性研究,其中男11例,女3例;左肩4例,右肩10例;年龄19~43岁,平均25.1岁。术后通过影像学报告、Constant-Murley评分和视觉模拟评分(visual analogue scale,VAS)对临床结果进行评估。结果 14例患者术后获得了12~36个月随访,平均22.8个月;切口长度4.5~6.5cm,平均4.9cm;喙突骨块与肩盂平齐率92.86%,在2~5点位置为100%。末次随访Constant-Murley评分87~100分,平均94.7分;VAS评分0.5~2.0分,平均1.3分;无患者复发肩关节脱位或半脱位,无骨块骨折,无内固定物松动、脱落等并发症出现。结论改良小切口Latarjet术治疗复发性肩关节前脱位伴明显肩盂骨性缺损的患者临床疗效良好,具有创伤小、疗效好、并发症少等优点。Objective To evaluate the results of modified mini-open Latarjet procedure for recurrent anterior shoul- der dislocation.Methods From January 2012 to December 2014 there are 14 patients,including 11 males and 3 females （4 left and 10 right）ranged from 19 to 43 years old with an average of 25.1 years old.The modified mini-open Latarjet procedure were performed for patients with anterior shoulder instability.The X-ray film and CT scan were repeated at the end of the final follow-up to find out if there was any progression of the degenerative change of the glenohumeral joint and if the transferred coracoid process united. The clinical effects were evaluated according to Constant-Murley scores and VAS scores.Results The average duration of the follow-up ranged from 12 to 36 months with an average of 22.8 months.The skin scare ranged from 4.5 to 6.5 cm with an average of 4.9 cm.According to the CT scanning at the final follow up, the graft was as at the same level of the glenoid in 92.86 % of the patients.Vertical positioning was per- fect in 100.0%.The Constant-Murley scores were from 87 to 100 with an average of 94.7.The VAS score was from 0.5 to 2.0.There were no cases of recurrent dislocation or subluxation,graft fractures and the screw loosened.Conclusion The modified mini-open latarjet procedure has shown satisfactory results with good graft positioning and minimal com- plications.

关 键 词：Latarjet术 复发性肩关节前脱位 骨缺损 

分 类 号：R684.7[医药卫生—骨科学]