关节镜治疗肩关节复发性前脱位伴纤维性Bankart损伤的疗效研究  

The effect of arthroscopic treatment of recurrent anterior dislocation of the shoulder joint with fibrous Bankart injury

作　　者：李朋[1] 吴剑波 王东[1] 赵峰[1] 田伟[1] 常峰[1] 张宇明[1] Peng Li;Jianbo Wu;Dong Wang;Feng Zhao;Wei Tian;Feng Chang;Yuming Zhang(Department of Orthopedics,the Fifth Clinical Medical College of Shanxi Medical University,Taiyuan 030012,China)

机构地区：[1]山西医科大学第五临床医学院骨科,太原030012

出　　处：《中华肩肘外科电子杂志》2023年第1期12-17,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的评价肩关节镜下行带线锚钉缝合修补盂唇术治疗肩关节复发性前脱位伴纤维性Bankart损伤的临床效果。方法回顾性分析本科自2019年7月至2021年7月采用肩关节镜下带线锚钉缝合修补盂唇术治疗肩关节复发性前脱位伴纤维性Bankart损伤的41例患者的临床资料和随访结果,其中男25例、女16例;年龄20~55岁,平均(30.4±5.5)岁;左侧13例、右侧28例;术前关节脱位次数为3~25次,平均(8.3±1.6)次。手术方式均为肩关节镜下带线锚钉缝合修补盂唇术。入组患者分别于术前1周和术后1、3、6、12个月随访并记录患肢外展90°时外旋角度值,前屈上举角度值,臂、肩、手残障评分(disability of the arm,shoulder and hand,DASH),Rowe评分及Constant-Murley评分。根据结果对其手术效果进行研究分析。结果针对符合条件的病例行临床资料分析和定期随访,随访病例肩关节术后都未复发脱位,均对手术效果满意。41例患者随访数据显示术前1周、术后12个月外展90°时外旋角度为(56.02±4.45)°和(86.02±2.59)°;前屈上举角度分别为(160.27±7.62)°和(175.68±3.39)°;DASH评分为(39.37±6.47)分和(10.76±2.84)分;Rowe评分为(40.73±7.38)分和(96.71±3.28)分;Constant-Murley评分为(76.44±4.06)分和(96.66±2.33)分,所得结果P值均<0.01,差异具有统计学意义。Constant-Murley分值较术前明显提高。结论肩关节镜下行带线锚钉缝合修补盂唇术治疗肩关节复发性前脱位伴纤维性Bankart损伤具有显著疗效,值得推广。Background Due to the extensive range of motion of the shoulder joint and the particular anatomical structure,the humerus head is prone to dislocation when moving.According to statistics,shoulder joint dislocation accounts for 1/2 of the total body joint dislocation.Long-term and repeated shoulder dislocation is the leading cause of shoulder joint pain and limited activity.After the initial dislocation,the anterior wall of the joint capsule,avulsion of the glenoid or glenoid margin,and posterior concave fracture of the humeral head in some patients were not repaired after reduction,and malunion occurred,leading to repeated dislocation,and previous dislocation was the most common.With the progress of arthroscopy technology and improvement of medical level,arthroscopy has advantages such as comprehensive observation of the injured site,high patient compliance,good postoperative appearance,etc.,and shoulder arthroscopy has gradually become the preferred treatment for recurrent shoulder dislocation.Objective To retrospectively analyze and evaluate the efficacy of the suture repair of the glenoid labrum with suture anchor for recurrent anterior dislocation with fibrous Bankart injury.Methods Forty-one patients with recurrent anterior dislocation of the shoulder joint and fibrous Bankart injury who underwent suture repair of glenoid labrum under shoulder arthroscopy in the People's Hospital of Shanxi Province were enrolled,and the clinical data were analyzed.Results For eligible cases,regular follow-up was conducted for one year.No recurrent dislocations were observed in the following cases,and all patients were satisfied with the surgical outcome.Follow-up data for 41 patients showed that the external rotation angles were(56.02±4.45)°and(86.02±2.59)°one week before and 12 months after surgery,respectively.The flexion and abduction angles were(160.27±7.62)°and(175.68±3.39)°,respectively.The DASH scores were(39.37±6.47)scores and(10.76±2.84)scores,the ROWE scores were(40.73±7.38)scores and(96.71±3.28)scores,

关 键 词：肩关节镜 肩关节复发性脱位 纤维性Bankart损伤 

分 类 号：R687.4[医药卫生—骨科学]