| 关节镜下Bankart损伤修复联合Remplissage填塞术治疗合并Hill-Sachs缺损的成年人复发性肩关节前脱位 |
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投稿时间：2021-04-17
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| 作者 | Author | 单位 | Address | E-Mail |
| 邢基斯 |
XING Ji-si |
广州中医药大学附属佛山中医院, 广东 佛山 528000
佛山市中医院运动医学科, 广东 佛山 528000 |
Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Foshan 528000, Guangdong, China |
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| 卢明峰 |
LU Ming-feng |
佛山市中医院运动医学科, 广东 佛山 528000 |
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| 赵立连 |
ZHAO Li-lian |
广州中医药大学附属佛山中医院, 广东 佛山 528000
佛山市中医院运动医学科, 广东 佛山 528000 |
Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Foshan 528000, Guangdong, China |
17820185108@163.com |
| 傅楚滢 |
FU Chu-ying |
广州中医药大学附属佛山中医院, 广东 佛山 528000
佛山市中医院运动医学科, 广东 佛山 528000 |
Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Foshan 528000, Guangdong, China |
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| 何利雷 |
HE Li-lei. |
佛山市中医院运动医学科, 广东 佛山 528000 |
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| 期刊信息：《中国骨伤》2021年，第34卷，第6期，第497-503页 |
| DOI：10.12200/j.issn.1003-0034.2021.06.003 |
| 基金项目: |
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中文摘要:
目的： 探讨关节镜下Bankart损伤修补术联合Remplissage填塞术治疗复发性肩关节前脱位合并Hill-Sachs损伤的方法和临床疗效。
方法： 回顾性分析2016年3月至2019年3月行关节镜下Bankart损伤修复治疗关节盂骨缺损<20%的复发性肩关节前脱位患者106例，其中男76例，女30例；年龄18~45（27.3±8.6）岁；左肩59例，右肩47例。手术前后采用肩关节主动活动度评估关节活动范围（range of motion，ROM），采用美国肩肘外科协会（American Shoulder and Elbow Surgeons，ASES）评分，Constant-Murley 评分及肩关节功能 Rowe 评分对肩关节功能和稳定性进行评估。
结果： 所有患者获得随访，均取得满意疗效，术后随访时间21~60（41.5±18.5）个月。1例术后出现感染，再次关节镜清理后感染控制，其余患者均未出现感染、关节腔积血及再脱位等临床并发症。肩关节前屈上举由术前的（158.33±15.72）°提高至末次随访的（169.43±10.04）°，内旋由术前T7（T4-T10）改变至末次随访T8（T5-T10）；平均体侧外旋、外展90°外旋分别由术前（58.46±15.51）°及（99.37±14.09）°减小至末次随访的（53.18±14.90）°及（92.52±13.10）°。ASES评分、Constant-Murley评分及Rowe评分均较术前明显改善。
结论： 关节镜下Bankart损伤修补联合 Remplissage填塞术治疗合并Hill-Sachs缺损的成年人复发性肩关节前脱位临床效果满意，虽然外旋功能较术前减弱，但能够有效重建肩关节功能，避免术后再脱位的发生。 |
| 【关键词】关节镜 肩关节 脱位 Hill-sachs损伤 |
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| Arthroscopic Bankart repair combined with Reimplissage for the treatment of recurrent anterior dislocation of shoulder in adults with Hill-Sachs defect |
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ABSTRACT
Objective: To investigate the method and clinical effects of the treatment of recurrent anterior dislocation of shoulder with Hill-Sachs injury by arthroscopic Bankart repair and Remplissage.
Methods: From March 2016 to March 2019,106 patients with recurrent anterior dislocation of shoulder with glenoid bone defect less than 20% underwent arthroscopic Bankart repair,including 76 males and 30 females,aged from 18 to 45 (27.3±8.6) years,59 cases of left shoulder and 47 cases of right shoulder. Range of motion (ROM),American Shoulder and Elbow Surgeons(ASES) score,Constant-Murley score and Rowe score were used to evaluate shoulder function and stability before and after operation.
Results: All patients were followed up,and the duration ranged from 21 to 60 months,with a mean of (41.5±8.5) months. One patient developed infection after operation,and the infection was controlled after arthroscopic debridement again. The remaining patients did not have clinical complications such as infection,intra-articular hematocele and redislocation. Shoulder flexion and lifting increased from (158.33±15.72) ° preoperatively to (169.43±10.04) ° at the latest follow-up,and internal rotation changed from T7 (T4 to T10) preoperatively to T8 (T5 to T10) at the latest follow-up;the average lateral external rotation and abduction 90 ° external rotation decreased from (58.46±15.51) ° preoperatively and (99.37±14.09) ° to (53.18±14.90) ° and (92.52±13.10) ° at the latest follow-up,respectively. The ASES score,Constant-Murley score and Rowe score were significantly improved.
Conclusion: The clinical effect of rehabilitation of Bankart repair combined with Remplissage under arthroscopy in the treatment of recurrent dislocation of shoulder joint in adults with Hill-Sachs defect is satisfactory. Although the external rotation function is weaker than that before operation,it can effectively reconstruct the shoulder function and avoid the occurrence of dislocation after operation |
| KEY WORDS Arthroscopes Shoulder joint Dislocations Hill-Sachs defect |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 邢基斯,卢明峰,赵立连,傅楚滢,何利雷.关节镜下Bankart损伤修复联合Remplissage填塞术治疗合并Hill-Sachs缺损的成年人复发性肩关节前脱位[J].中国骨伤,2021,34(6):497~503 |
| 英文格式: | XING Ji-si,LU Ming-feng,ZHAO Li-lian,FU Chu-ying,HE Li-lei..Arthroscopic Bankart repair combined with Reimplissage for the treatment of recurrent anterior dislocation of shoulder in adults with Hill-Sachs defect[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(6):497~503 |
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