创伤性肩关节前不稳定康复治疗与手术治疗效果分析  

Analysis on the Results of Treatment of Traumatic Anterior Shoulder Instability

作　　者：王予彬[1] 王惠芳[2] 李文峰[2] 张伟佳[2] 朱良雁 李国平[1] 

机构地区：[1]国家体育总局运动医学研究所体育医院运动创伤外科,北京100061 [2]北京军医进修学院创伤中心304医院康复科

出　　处：《中国运动医学杂志》2002年第6期561-564,共4页Chinese Journal of Sports Medicine

摘　　要：目的 :分析影响创伤性肩关节前不稳定患者的康复治疗与修复重建手术治疗的效果。方法 :5 8例患者根据临床症状、体征 ,盂唇损伤的范围 ,关节囊撕裂、松弛的范围和关节不稳定的程度 ,分别选择康复治疗(3 9例 )、康复治疗无效改成手术治疗 (5例 )与手术治疗 (1 4例 )。结果 :本组病例平均随访 2 4个月 ,康复治疗组 4例剧烈活动后肩部不适 ,3例后伸受限 1 0°,1例前屈受限 2 0°。康复治疗无效改成手术治疗组 5例 ,手术治疗组 1 4例 ,其中后伸活动受限 2例(1 0°) ,剧烈活动后肩前部不适 1例 ,其余病例症状消失 ,关节活动度正常。结论 :创伤性肩关节前不稳定的康复治疗可避免手术创伤 ,疗效满意 ,但治疗周期较长 ,治疗效果受病程长短、患者配合治疗的情况以及肩关节盂唇、前关节囊损伤程度的影响。康复治疗后症状无改善、甚至加重 ,或者前关节囊明显撕裂、盂唇撕脱、肩关节明显不稳定者需采用手术治疗。肩关节盂唇、前关节囊修复成形术不破坏正常关节稳定结构 ,关节功能恢复良好。肩关节稳定结构的损伤程度 ,如前关节囊严重损伤。Aim To analyze the results of the rehabilitation and surgical treatment of traumatic anterior instability of shoulder. Methods 58 patients diagnosed as traumatic anterior instability of shoulder according to their symptoms, clinical signs, X-ray film and double contrast CT were investigated. Among them, 14 were treated with the operation, which included repair of labrum tears and anterior capsular imbrications of shoulder, and the others were treated with the rehabilitation program. Results The satisfactory results were gained after following-up 24 months in average. Most patients in the rehabilitation group were resumed from previous symptoms and signs except minor pain of the shoulder after strenuous exercises in 4 patients and less than 20°limitation of shoulders in 4 patients. 5 patients were operated after failure in the rehabilitation treatment. The patients after operation were resumed from previous symptoms and returned to normal joint function except feeling uncomfortable sometimes after strenuous sports in 1 patient and 10° of limitation of shoulder movement in 2 patients. Conclusion The current study has proved the satisfactory effects of the rehabilitation program and surgical treatment in traumatic anterior instability of shoulder. Delayed treatment and injured degree of labrum and anterior joint capsule of shoulder would have influences on the curative effect.

关 键 词：疗效 创伤性肩关节前不稳定 康复治疗 手术治疗 

分 类 号：R684.7[医药卫生—骨科学]