关节镜下Bankart修复与骨性Bankart修复治疗复发性肩关节前脱位的疗效观察  

Observation on therapeutic effect of Bankart repair and bone Bankart repair under arthroscopy in treatment of recurrent anterior dislocation of shoulder joint

作　　者：赵广义 张壮岱 冯志军 赵艳丽 赵芬 胡世伟 ZHAO Guangyi;ZHANG Zhuangdai;FENG Zhijun;ZHAO Yanli;ZHAO Fen;HU Shiwei(Department of Orthopaedics,PLA 980 Hospital,Shijiazhuang,Hebei 050082,China;不详)

机构地区：[1]中国人民解放军联勤保障部队第九八〇医院骨科,河北石家庄050082 [2]河北医科大学第三医院关节4科,河北石家庄050051

出　　处：《中国骨与关节损伤杂志》2023年第11期1143-1147,共5页Chinese Journal of Bone and Joint Injury

基　　金：军事课题项目(21XLS26);河北省卫健委课题(20200250,20200260)。

摘　　要：目的观察关节镜下Bankart修复与骨性Bankart修复治疗复发性肩关节前脱位的临床疗效。方法回顾性分析自2016-01—2019-12诊治的110例军事训练伤致复发性肩关节前脱位,术前进行肩关节三维CT扫描,并根据有无骨折块分为单纯Bankart损伤组与骨性Bankart损伤组,以此为依据设计关节镜下Bankart修复术与骨性Bankart修复术。比较两组术前与术后肩关节功能Constant评分、肩关节功能Rowe评分、疼痛VAS评分。结果两组均获得随访,随访时间24~48个月,平均36.4个月。手术均顺利完成,术后切口均一期愈合,无感染、神经血管损伤等并发症。术后24个月X线片及CT结果显示骨性Bankart损伤组肩关节骨折愈合良好,骨质内锚钉固定牢固,无松动、脱出。两组术前、末次随访时的肩关节功能Constant评分、肩关节功能Rowe评分、疼痛VAS评分组间比较,差异无统计学意义(P>0.05)。结论采用关节镜下Bankart修复术及骨性Bankart修复术治疗复发性肩关节前脱位具有创伤小、恢复快以及术后肩关节稳定性好的特点,术后无再脱位病例;特别是对于骨性Bankart损伤,关节镜下复位骨折使关节盂形态可以在术后恢复正常,恢复的关节盂骨性面积增加了骨性稳定的基础。Objective To observe the clinical efficacy of Bankart repair and bone Bankart repair under arthroscopy in the treat⁃ment of recurrent anterior dislocation of the shoulder joint.Methods A retrospective analysis was conducted on 110 cases of recurrent anterior dislocation of the shoulder caused by military training diagnosed and treated from January 2016 to December 2019.All patients with recurrent anterior dislocation of the shoulder underwent preoperative three-dimensional CT scans of the shoulder joint,and were divided into a simple Bankart injury group and a bone Bankart injury group based on the presence or absence of fracture blocks.Based on this,arthroscopic Bankart repair and bone Bankart repair were designed.The preoperative and postoperative shoulder joint function Constant score,shoulder joint function Rowe score,and pain VAS score were com⁃pared between the two groups.Results Both groups were followed up for 24-48 months,with an average of 36.4 months.The surgery was successfully completed,and the postoperative wounds healed at levelⅠwithout complications such as infection or neurovascular injury.The X-ray and CT results 24 months after surgery showed good healing of the shoulder joint fracture block,firm fixation of the intramedullary anchor screw,no loosening or detachment.There was no statistically significant differ⁃ence(P>0.05)in the preoperative and final follow-up shoulder joint function Constant score,shoulder joint function Rowe score,and pain VAS score between the two groups.Conclusion The use of arthroscopic Bankart repair and bone Bankart re⁃pair for the treatment of recurrent shoulder dislocation has the characteristics of minimal trauma,fast recovery,good postopera⁃tive shoulder stability.There are no re-dislocations after surgery;especially for bony Bankart injuries,arthroscopic reduction of the fracture block can restore the shape of the shoulder pelvis to normal after surgery,and the restored bone area of the shoulder pelvis increases the foundation of bone stability.

关 键 词：复发性肩脱位 BANKART 骨性Bankart 关节镜 

分 类 号：R684.7[医药卫生—骨科学]