骨性和软组织手术治疗创伤性肩复发性前脱位疗效观察  

Bone and soft tissue surgery in the treatment of traumatic recurrent anterior dislocation of shoulder

作　　者：张洪鑫 翟龙地 杨晓明 潘昭勋 孙超 刘丰杰 薛兵 Zhang Hongxin;Zhai Longdi;Yang Xiaoming;Pan Zhaoxun;Sun Chao;Liu Fengjie;Xue Bin(Army 80th Group Military Hospital,Weifang,Shandong)

机构地区：[1]解放军第80集团军医院骨科,山东潍坊 [2]解放军第80集团军医院军事训练伤防治技术指导站,山东潍坊 [3]解放军第80集团军医院信息科,山东潍坊

出　　处：《运动科学与健康研究》2025年第1期55-60,共6页Research on Sports Science and Health

摘　　要：目的:探讨骨性和软组织手术治疗创伤性肩复发性前脱位临床效果。方法:回顾性分析2010年1月~2022年7月到解放军第80集团军医院骨科手术治疗的创伤性肩复发性前脱位73例。根据手术方式分为两组。(1)小切口骨性手术组7例:单纯喙突联合肌腱转位组1例、喙突转位联合盂唇修复组5例、髂骨移植联合盂唇组1例,年龄22~50岁,平均年龄29.4岁。(2)软组织修复组66例:单纯盂唇组49例,男性42例,女性7例,年龄18~53岁,平均26.5岁;盂唇联合Remplissage组8例,女性2例,男性6例,年龄19~44岁,平均29.4岁;盂唇联合肩袖手术组9例,男性3例,女性6例,年龄22~68岁,平均年龄49.4岁。通过描述性研究,分析两组患者术后再脱位率、CS评分、术后并发症、末次随访患者ROWE评分。结果:患者随访12~149个月,平均63.8个月。平均手术时间:骨性手术组80.6min,软组织组95.4min;再脱位例数:骨性组0例,软组织组3例;平均术后CS,ROWE评分较术前显著提高(P<0.001);术中出血量:骨性手术组321.5ml,软组织手术53.7ml;术后并发症:骨性组1例(空心螺钉松动),软组织组7例(铆钉松动2例,深部感染1例,出血1例,脱位3例);两组均无神经损伤病例。结论:骨性和软组织手术治疗都能有效治疗创伤性肩复发性前脱位。Objective:Investigate the clinical effect of bone and soft tissue surgery in the treatment of traumatic recurrent dislocation of shoulder.Methods:Seventy-three cases of recurrent shoulder dislocation treated in the Army 80th Group Military Hospital from January 2010 to July 2022 were analyzed retrospectively.According to the surgical methods,they were divided into two groups:first group,seven cases in the small incision bone surgery group,one case in the simple coracoid osteotomy combined with conjoined tendon transposition group,five cases in the coracoid process transposition combined with Labrum repairs,and one case in the iliac bone transplantation combined with Labrum repairs.Age from 22 to 50 years,with an average age of 29.4 years.Second group:Sixty-six patients in the soft tissue repair group,including 49 patients in the simple labrum repair group(42 males and 7 females,aged 18~53 years,average age 26.5 years),eight cases in the combined labrum repair and Remplissage group(2 females and 6 males,aged 19~44 years,average of 29.4 years),nine cases in the Labrum repair combined with rotator cuff surgery group(3 males and 6 females,aged from 22 to 68 years,average age of 49.4 years).Through descriptive research,the postoperative redislocation rate,CS score,postoperative complications and Rowe score of patients in the last follow-up were analyzed.Results:The patients were followed up for 12~149 months,average of 63.8 months.The average operation time was 80.6 minutes in the bone operation group and 95.4 minutes in the soft tissue group.Cases of redislocation:0 in bone group,3 in soft tissue group.The average postoperative CS and Rowe scores were significantly higher than those before operation(P<0.001).Intraoperative blood loss:321.5ml in bone surgery group,53.7ml in soft tissue surgery group.Postoperative complications:1 case in the bone group(hollow screw failure),7 cases in the soft tissue group(rivet loosening in 2 cases,deep infection in 1 case,bleeding in 1 case,dislocation in 3 cases);There were no cas

关 键 词：肩关节 复发性脱位 喙突转位 盂唇修复 小切口 

分 类 号：R684.7[医药卫生—骨科学]