肩胛冈骨块移植骨横钉固定修复骨性Bankart损伤  

Bone block from scapular spinetransversely fixed with bone allograft pin for repairing bony Bankart lesion

作　　者：鹿鸣[1,2] 刘玉杰 申学振[3] 高奉 胡波[5] 刘雨丰 LU Ming;LIU Yu-jie;SHEN Xue-zhen;GAO Feng;HU Bo;LIU Yu-feng(The Fourth Comprehensive Service and Support Center of the PLA Beijing Administration of Veterans Service Affairs Department,Beijing 100191,China;Department of Sports Medicine,General Hospital of PLA,Belling 100853,China;Capital Medical University Beifing Luhe Hospital,Beijing 100000,China;National Institute of Sports Medicine,Beijing 100000,China;Beijing Chaoyang Integrative Medicine Emergency Medical Center,the Second Department of Orthopedics,Beijing 100022,China.)

机构地区：[1]解放军总医院骨科,北京市100853 [2]中国人民解放军驻北京市老干部服务管理局第四综合服务保障中心,北京市100191 [3]首都医科大学附属北京潞河医院,北京市100000 [4]国家体育总局运动医学研究所,北京市100000 [5]北京朝阳中西医结合急诊抢救中心骨二科,北京市100022

出　　处：《中国矫形外科杂志》2018年第14期1333-1337,共5页Orthopedic Journal of China

摘　　要：[目的]探索采用自体肩胛冈骨块移植,同种异体骨横穿钉固定修复骨性Bankart损伤。[方法]根据探查和术前肩关节CT扫描三维重建骨缺损情况,关节镜探查确认肩关节骨性Bankart损伤。取自体肩胛冈外1/3骨块,将骨块修整后钻孔,移植到肩盂骨性缺损处,采用同种异体骨横钉将骨块固定在肩盂缺损处。骨钉头端穿入缝线,捆扎缝合软组织及骨块。采用美国肩肘外科评分、Rows评分和CT扫描三维重建及X线片等影像学检查评价肩关节的稳定性和功能。[结果]共5例患者,美国肩肘外科评分由术前(4.20±1.10)分增加至末次随访时(12.4±0.55)分。Rows评分由术前(13.00±4.47)分增加至末次随访时(93.00±2.74)分。[结论]采用自体肩胛冈骨块移植、同种异体骨钉固定修复骨性Bankart损伤,骨块取材方便,生物骨钉固定牢固,免用高值耗材,方法可行。[Objective] To explore the technique of bone autograft from scapular spine fixed with bone cortical allograft pin for repairing bony Bankart lesion. [Methods] Based on preoperative CT scan that revealed glenoid bony defect, arthroscopic ex- ploration was conducted to confirm the bony Bankart lesions further. After that, a bone block harvested from the lateral third scapular spine was trimmed, drilled two holes on it and then implanted on the glenoid defect. Lastly, the bone block was secured with the glenoid by transversely tapping two bone cortical allograft pins, in which sutures through the pin hole at top part were eventually stitched with the surrounding capsule. The American Shoulder and Elbow Surgery Scores, Rows Rating System for Bankart repair, the reconstruction of 3D-CT scan and X-ray images were used to evaluate the stability and function of the shoulder joint. [Results] A total of 5 patients underwent this procedure. The American Shoulder and Elbow Surgery Scores significantly increased from （4.20± 1.10） before surgery to （12.4±0.55） at the latest follow-up, additionally, the Rows scores increased from （13.00±4.47） before surgery to （93.00±2.74） at the latest follow-up. [Conclusion] This technique of bone autograft from scapular spine fixed with bone cortical allograft pin is clinically feasible for repairing bony Bankart lesion with benefits of bone autograft accessible and fixation with biocompatible material.

关 键 词：BANKART损伤 骨缺损 骨移植 肩关节不稳 

分 类 号：R683.41[医药卫生—骨科学]