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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作者Author单位AddressE-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  
卢明峰 LU Ming-feng 佛山市中医院运动医学科, 广东 佛山 528000  
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  
何利雷 HE Li-lei. 佛山市中医院运动医学科, 广东 佛山 528000  
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:
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
 
Arthroscopic Bankart repair combined with Reimplissage for the treatment of recurrent anterior dislocation of shoulder in adults with Hill-Sachs defect
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
 
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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