双EndoButton弹性固定Latarjet手术治疗军事训练伤致肩关节前脱位伴关节盂骨缺损的疗效分析  

Effectiveness analysis of double EndoButton suture fixation Latarjet procedure for treatment of anterior shoulder dislocation with glenoid bone defect caused by military training injuries

作　　者：李涵 闫增龙 李灏坤 李宝 杜树远 刘欣伟 LI Han;YAN Zenglong;LI Haokun;LI Bao;DU Shuyuan;LIU Xinwei(Department of Orthopedics,the General Hospital of Northern Theater Command of Chinese PLA,Rescue Center of Severe Wound and Trauma of Chinese PLA,Shenyang Liaoning,110016,P.R.China;The 3rd Department of Orthopedics,Liaoning Provincial People’s Hospital,Shenyang Liaoning,110016,P.R.China)

机构地区：[1]中国人民解放军北部战区总医院骨科全军重症战创伤救治中心,沈阳110016 [2]辽宁省人民医院骨三科,沈阳110016

出　　处：《中国修复重建外科杂志》2024年第6期660-665,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：2021沈阳市科学技术计划-公共卫生研发专项(21-173-9-77)。

摘　　要：目的探讨双EndoButton弹性固定Latarjet手术治疗军事训练伤致肩关节前脱位伴关节盂骨缺损的临床疗效。方法回顾分析2021年8月—2022年12月收治且符合选择标准的14例因军事训练伤致肩关节前脱位伴关节盂骨缺损的患者临床资料。患者均为男性;年龄21~38岁,平均26.8岁。初次脱位至手术时间6~15个月,平均10.2个月。肩关节前脱位5~12次,平均8.2次。关节盂骨缺损均>10%,其中10%~15%5例,15%~20%8例,24%1例。均采用双EndoButton弹性固定Latarjet手术治疗。记录患者手术时间及并发症发生情况;手术前后采用美国肩肘外科协会(ASES)评分、Rowe评分、肩关节不稳定严重程度指数评分(ISIS)及疼痛视觉模拟评分(VAS)评估肩关节功能和疼痛;记录肩关节活动度,包括前屈、0°外旋、外展90°外旋;术后复查肩关节三维CT,评估骨块位置、愈合情况和骨块吸收情况。结果患者均顺利完成手术,手术时间100~150 min,平均119.7 min;均未出现感染及血管、神经损伤等并发症。所有患者均获随访,随访时间12~20个月,平均15.6个月。随访期间4例患者出现骨块分离、吸收并复发前脱位,肩关节恐惧试验呈阳性;其余患者影像学检查示骨块愈合良好,愈合时间3~7个月,平均4.7个月,未复发前脱位。末次随访时,患者肩关节活动度、ASES评分、Rowe评分、ISIS评分及VAS评分均较术前显著改善,差异有统计学意义(P<0.05)。结论双EndoButton弹性固定Latarjet手术治疗军事训练伤致肩关节前脱位伴关节盂骨缺损临床疗效较满意。Objective To investigate the effectiveness of double EndoButton suture fixation Latarjet procedure in the treatment of shoulder anterior dislocation with glenoid bone defect caused by military training injuries.Methods The clinical data of 14 patients with anterior shoulder dislocation with glenoid bone defect due to military training injuries who met the selection criteria and admitted between August 2021 and December 2022 were retrospectively analyzed.All patients were male,the age ranged from 21 to 38 years,with an average of 26.8 years.The time from initial dislocation to operation was 6-15 months,with an average of 10.2 months.Anterior shoulder dislocation occurred 5-12 times,with an average of 8.2 times.All glenoid bone defects were more than 10%,including 5 cases of 10%-15%,8 cases of 15%-20%,and 1 case of 24%.All patients were treated by double EndoButton suture fixation Latarjet procedure.The operation time and complications were recorded.The shoulder function and pain were evaluated by the American Association for Shoulder and Elbow Surgery(ASES)score,Rowe score,Instability Severity Index Score(ISIS),and visual analogue scale(VAS)score before and after operation.The range of motion of the shoulder was recorded,including forward flexion,0°external rotation,and abduction 90°external rotation.The position,healing,and resorption of the bone mass were evaluated by three-dimensional CT of shoulder joint after operation.Results All patients successfully completed the operation,and the operation time was 100-150 minutes,with an average of 119.7 minutes.There was no complications such as infection,vascular and nerve injury.All patients were followed up 12-20 months,with an average of 15.6 months.During the follow-up,4 patients had bone mass separation,absorption,and recurrent anterior dislocation,and the shoulder joint fear test was positive.Imaging of the remaining patients showed that the bone mass healed well,no anterior dislocation recurrence occurred,and the healing time was 3-7 months(mean,4.7 months).At

关 键 词：军事训练伤 肩关节前脱位 关节盂骨缺损 Latarjet手术 

分 类 号：R826[医药卫生—临床医学]