关节镜下双排双滑轮技术治疗IdebergⅠA型肩胛盂骨折的疗效  

Efficacy of arthroscopic double-row double-pulley technique in the treatment of Ideberg type IA scapular glenoid fracture

作　　者：白云鹏 孙卫兵 池宸申 王苗 丁浩亮 孙健[1] Bai Yunpeng;Sun Weibing;Chi Chenshen;Wang Miao;Ding Haoliang;Sun Jian(Department of Orthopedics,Jiading Branch of Shanghai General Hospital/Jiangqiao Hospital of Jiading District,Shanghai 201803,China)

机构地区：[1]上海市第一人民医院嘉定医院,上海市嘉定区江桥医院骨科,上海201803

出　　处：《中华创伤杂志》2024年第1期73-79,共7页Chinese Journal of Trauma

基　　金：上海市嘉定区自然科学研究项目(JDKW-2021-0013)。

摘　　要：目的探讨关节镜下双排双滑轮技术治疗IdebergⅠA型肩胛盂骨折的临床疗效。方法采用回顾性病例系列研究分析2018年1月至2021年12月上海市第一人民医院嘉定医院收治的16例IdebergⅠA型肩胛盂骨折患者的临床资料,其中男10例,女6例;年龄25~65岁[(42.9±5.1)岁]。采用关节镜辅助复位双排双滑轮技术治疗。记录手术时间。术后3个月行肩关节CT三维重建评估骨折移位和愈合情况。术前,术后3、6、12个月及末次随访时采用改良美国加州大学洛杉矶分校(UCLA)评分及Constant-Murley评分评估肩关节功能,采用视觉模拟评分(VAS)评估疼痛情况。观察并发症发生情况。结果患者均获随访12~36个月[(20.3±4.4)个月]。手术时间为60~90 min[(74.7±8.9)min]。术后3个月复查肩关节CT三维重建示骨折无明显再移位,均获骨性愈合。术后3个月改良UCLA评分、Constant-Murley评分、VAS分别为(30.4±0.4)分、(84.3±1.4)分、2.0(1.3,3.0)分,均较术前的(21.1±0.5)分、(56.4±1.3)分、5.0(5.0,6.0)分改善(P<0.05)。术后6个月改良UCLA评分、Constant-Murley评分、VAS分别为(33.1±0.4)分、(91.0±0.5)分、1.0(1.0,2.0)分,均较术后3个月改善(P<0.05)。术后12个月改良UCLA评分、Constant-Murley评分、VAS分别为(33.5±0.3)分、(92.6±0.6)分、1.0(0.3,1.8)分,与术后6个月差异均无统计学意义(P>0.05)。末次随访时改良UCLA评分、Constant-Murley评分、VAS分别为(33.8±0.8)分、(93.7±1.8)分、1.0(0.0,1.0)分,与术后12个月差异均无统计学意义(P>0.05)。术后未出现伤口感染、神经血管损伤、肩关节僵硬等并发症。结论关节镜下双排双滑轮技术治疗IdebergⅠA型肩胛盂骨折,手术时间短,骨折愈合率高,肩关节功能恢复良好,疼痛减轻,无常见并发症。Objective To investigate the clinical efficacy of arthroscopic double-row double-pulley technique in the treatment of Ideberg type IA scapular glenoid fracture.Methods A retrospective case series study was conducted to analyze the clinical data of 16 patients with Ideberg type IA scapular glenoid fracture admitted to Jiading Branch of Shanghai General Hospital from January 2018 to December 2021,including 10 males and 6 females,aged 25-65 years[(42.9±5.1)years].The patients were treated with arthroscope-assisted reduction and double-row double-pulley technique.The operation time was recorded.Three-dimensional reconstruction of the shoulder joint with CT was performed to assess fracture displacement and healing.Modified University of California Los Angeles(UCLA)score and Constant-Murley score were used to evaluate shoulder function and Visual Analogue Scale(VAS)score was used to evaluate pain before surgery,at 3,6,12 months after surgery and at the last follow-up.The complications were observed.Results All the patients were followed up for 12-36 months[(20.3±4.4)months].The operation time was 60-90 minutes[(74.7±8.9)minutes].Three-dimensional construction of the shoulder joint with CT performed at 3 months after surgery showed that there was no fracture re-displacement and all the patients had bone union.The modified UCLA score,Constant-Murley score and VAS score at 3 months after surgery were(30.4±0.4)points,(84.3±1.4)points and 2.0(1.3,3.0)points,respectively,which were significantly improved compared with those before surgery[(21.1±0.5)points,(56.4±1.3)points and 5.0(5.0,6.0)points respectively](P<0.05).The modified UCLA score,Constant-Murley score and VAS score at 6 months after surgery were(33.1±0.4)points,(91.0±0.5)points and 1.0(1.0,2.0)]points respectively,which were significantly improved compared with those at 3 months after surgery(P<0.05).The modified UCLA score,Constant-Murley score and VAS score at 12 months after surgery were(33.5±0.3)points,(92.6±0.6)points and 1.0(0.3,1.8)points respecti

关 键 词：肩骨折 关节镜 缝合锚 

分 类 号：R687.3[医药卫生—骨科学]