喙突截骨移位治疗复发性肩关节前脱位研究进展  

Research Progress in the Treatment of Recurrent Anterior Dislocation of the Shoul-der by Rostral Osteotomy Transposition

作　　者：罗祥 李克文[2] 

机构地区：[1]青海大学研究生院,青海 西宁 [2]青海大学附属医院关节外科,青海 西宁

出　　处：《临床医学进展》2023年第11期17904-17910,共7页Advances in Clinical Medicine

摘　　要：目的:探讨喙突截骨移位治疗复发性肩关节前脱位临床研究相关进展,为治疗复发性肩关节前脱位相关研究提供参考。方法:查阅国内外有关喙突移位阻滞术治疗肩关节前脱位的研究文献,总结研究进展。结果:行喙突移位阻滞术时,确保移植物的理想位置应在关节盂中纬线下方,并与关节盂表面齐平。手术过程中应尽可能保留喙突骨块移植物的血液供应,促进骨块的愈合。同时尽量降低移植骨块溶解吸收。机械刺激及相关应力也会导致骨质减少和骨吸收。术后行合适的康复锻炼能尽早地恢复肩关节活动度,减少肩关节活动度的损失。正确的骨块处理,及合适的位置、固定,加上精确的手术技术和对局部解剖结构的准确了解,减少不必要损伤,能降低关节脱位复发率、神经系统并发症、僵硬及外旋损失及骨不愈合。使Latarjet手术显示出明显的优势,提高其稳定性、患者满意度和运动恢复能力。结论:Latarjet截骨术是治疗复发性肩关节前脱位的最可靠和最常用的手术之一,精细化操作能降低手术并发症,然而,相关方面无明确指导规范。术中骨块位置固定、血运等问题对临床疗效的影响,术后肩关节相关并发症及移植骨块的骨质溶解仍未解决,需要进一步进行长期的研究。Objective: To investigate the progress related to the clinical study of rostral osteotomy transposi-tion for the treatment of recurrent anterior dislocation of the shoulder, and to provide reference for the study related to the treatment of recurrent anterior dislocation of the shoulder. Methods: To re-view the domestic and international research literature on rostral translocation block for the treatment of anterior dislocation of the shoulder and to summarize the research progress. Results: When performing a rostral transfer block, ensure that the ideal position of the graft should be be-low the equator line of the articular glenoid and flush with the surface of the articular glenoid. The blood supply to the rostral bone block graft should be preserved as much as possible during the procedure to promote healing of the bone block. It is also important to minimize lysis and resorp-tion of the grafted bone block. Mechanical stimulation and associated stresses can also lead to bone loss and resorption. Appropriate postoperative rehabilitation can restore shoulder mobility as early as possible and minimize the loss of shoulder mobility. Correct handling of the bone block, and proper positioning and fixation, combined with precise surgical technique and accurate knowledge of the local anatomy to minimize unnecessary injuries, reduces the recurrence rate of dislocation, neurological complications, stiffness and loss of external rotation, and non-healing of the bone. This enables the Latarjet procedure to show significant benefits in terms of improved stability, patient satisfaction and recovery of motion. Conclusions: Latarjet osteotomy is one of the most reliable and commonly used procedures for the treatment of recurrent anterior dislocation of the shoulder, and refinement of the operation reduces surgical complications;however, there is no clear guideline specification for the related aspects. The impact of intraoperative bone block position fixation and hemodynamic problems on clinical outcomes, postoperative shou

关 键 词：肩关节前脱位 喙突移位阻滞术 喙突截骨 骨块吸收 

分 类 号：R68[医药卫生—骨科学]