肩关节镜下处理骨性Bankart损伤的现状  

Current arthroscopic treatment of bony Bankart lesions

作　　者：王星宇 谢水华 丁浩 张文庆 王小鹏 刘霞 WANG Xing-yu;XIE Shui-hua;D;ZHANG Wen-qing;WANG Xiao-peng;L(School of Graduate, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China;Department of Orthopeadics, Affiliated Integrate Chinese and Western Hospital, Jiangxi University of Tradition- al Chinese Medicine, Nanchang 330006, China;Department of Oncology, Jiangxi Maternal and Child Health Hospital, Nan- chang 330006, China)

机构地区：[1]江西中医药大学研究生院,南昌330004 [2]江西中医药大学附属中西医结合医院骨一科,南昌330006 [3]江西省妇幼保健院肿瘤科,南昌330006

出　　处：《中国矫形外科杂志》2018年第12期1120-1125,共6页Orthopedic Journal of China

摘　　要：骨性Bankart损伤是与肩关节前方不稳定相伴随存在的肩盂前缘的骨折或骨缺损,其发生率在肩关节前脱位中占4%~70%,临床及生物力学研究显示,当骨缺损的面积>20%~25%时,单纯行软组织的修复如Bankart修复术效果不佳,建议行骨质重建,如Latarjet术、取自体髂骨或异体骨植骨术等。目前行切开手术修复治疗已十分娴熟,但开放手术存在创伤大、出血多、对关节活动度影响大等缺点。随着关节镜工具及技术的发展,目前可以在全关节镜下处理骨性Bankart损伤。本文就骨性Bankart损伤的分类、生物力学背景、临床评估及关节镜下处理骨性Bankart损伤的手术方法及临床疗效作一综述,为临床骨科医师在行肩关节镜治疗此病时提供借鉴与参考。Bony Bankart lesions is the fractures or deficiency of anterior glenoid rim associated with anterior instability of the shoulder, with incidence ranged from 4% to 70% in anterior dislocation of shoulder. Clinical and biomechanical studies have indicated that it is insufficient to perform a Bankart repair alone in the patients with bone loss of greater than 20%-25% of the glenoid surface area. Various bony reconstructions have been recommended for this lesion, such as Latarjet procedure, autologous iliac crest or allograft bone graft procedures. The open surgery has the disadvantage of invasive trauma, more blood loss and severe impact on the motion of joint despite shorter learning curve. With advances in arthroscopic instruments and techniques, arthroscopic reconstruction of glenoid bone defects has become reliable treatment. The purpose of this article is to summarize the classification, biomechanical background and clinical evaluation of bony Bankart lesions, as well as the arthroscopic techniques and clinical efficacy, to provide a reference for clinic orthopedic surgeons.

关 键 词：关节镜 骨性Bankart损伤 肩关节不稳定 综述 

分 类 号：R687.4[医药卫生—骨科学]