两种方法整复合并Hill-Sacks损伤的难复性肩关节喙突下脱位
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作者Author单位AddressE-Mail
张如意 ZHANG Ru-yi 首都医科大学石景山教学医院北京市石景山医院骨创伤科, 北京 100043 Department of Orthopaedic Trauma, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing 100043, China zhangry301@hotmail.com 
云才 YUN Cai 首都医科大学石景山教学医院北京市石景山医院骨创伤科, 北京 100043 Department of Orthopaedic Trauma, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing 100043, China  
杨涛 YANG Tao 首都医科大学石景山教学医院北京市石景山医院骨创伤科, 北京 100043 Department of Orthopaedic Trauma, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing 100043, China  
张易 ZHANG Yi 首都医科大学石景山教学医院北京市石景山医院骨创伤科, 北京 100043 Department of Orthopaedic Trauma, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing 100043, China  
朱建华 ZHU Jian-hua 首都医科大学石景山教学医院北京市石景山医院骨创伤科, 北京 100043 Department of Orthopaedic Trauma, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing 100043, China  
刘峰 LIU Feng 首都医科大学石景山教学医院北京市石景山医院骨创伤科, 北京 100043 Department of Orthopaedic Trauma, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing 100043, China  
张立超 ZHANG Li-chao 首都医科大学石景山教学医院北京市石景山医院骨创伤科, 北京 100043 Department of Orthopaedic Trauma, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing 100043, China  
苏鹏 and SU Peng 首都医科大学石景山教学医院北京市石景山医院骨创伤科, 北京 100043 Department of Orthopaedic Trauma, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing 100043, China  
期刊信息:《中国骨伤》2022年,第35卷,第12期,第1115-1120页
DOI:10.12200/j.issn.1003-0034.2022.12.002
基金项目:
中文摘要:

目的:评价对抗牵引法整复合并Hill-Sacks损伤的难复性肩关节喙突下脱位的临床疗效。

方法:回顾性分析2013年12月至2020年6月收治的56例合并Hill-Sacks损伤的难复性肩关节前脱位患者,脱位类型均为喙突下脱位。在肩关节腔注射麻醉下分别采用对抗牵引法(试验组)和传统Hippocrates法(对照组)进行复位,各28例。其中试验组男11例,女17例;年龄(61.95±19.32)岁;左侧9例,右侧19例。对照组男12例,女16例;年龄(63.13±12.75)岁;左侧11例,右侧17例。治疗前后分别对两组疗效进行评价,包括复位成功率、复位时长、复位成功距离受伤时间、并发症和功能恢复情况(肩关节Constant评分)。

结果:试验组和对照组复位成功率分别为92.86%(26/28)和67.86%(19/28),差异有统计学意义(P<0.05);单纯复位时长分别为(4.25±2.13) min和(6.31±1.69) min,差异有统计学意义(P<0.05);复位成功距离受伤时间分别为(9.16±0.94) h和(8.94±1.31) h,差异无统计学意义(P>0.05)。试验组无血管神经损伤和骨折等并发症发生,对照组2例腋神经损伤,1例肱骨头骨折。试验组和对照组肩关节Constant评分分别为(92.34±5.62)分和(90.91±4.73)分,差异无统计学意义(P>0.05)。

结论:采用肩关节腔注射麻醉下对抗牵引法整复合并Hill-Sacks损伤的难复性肩关节喙突下脱位的成功率高,并发症相对较少。
【关键词】肩关节前脱位  喙突下脱位  Hill-Sacks损伤  对抗牵引法  Hippocrates法
 
Countertraction method for reduction of irreducible subcoracoid dislocation of the shoulder joint with Hill-Sacks lesion
ABSTRACT  

Objective: To investigate clinical outcomes of countertraction method in treating irreducible subcoracoid dislocation of shoulder joint combined with Hill-Sacks injury.

Methods: A total of 56 patients with irreducible subcoracoid dislocation of the shoulder joint combined with Hill-Sacks injury admitted from December 2013 to June 2020 were retrospectively analyzed. Under the anesthesia of shoulder joint cavity injection, the reduction was performed by using anti-traction method (experimental group) and traditional Hippocrates method (control group), 28 cases in each group. There were 11 males and 17 females in experimental group, with an average age of (61.95±19.32) years old, 9 cases on the left side, and 19 cases on the right side. Twelve males and 16 females in control group, with an average age of (63.13±12.75) years old, 11 cases on the left side, 17 cases on the right side. The curative effects between two groups were evaluated before and after operation, including the success rate of reduction, the duration of reduction, the distance from successful reduction to injury, complications and functional rehabilitation(Constant score of shoulder joint).

Results: The success rates of reduction in experimental group and control group were 92.86%(26/28) and 67.86% (19/28), respectively, and the difference was statistically significant (P<0.05). The duration of simple reduction was (4.25±2.13) min and (6.31±1.69) min, the difference was statistically significant (P<0.05);the time from successful reduction to injury was (9.16±0.94) h and (8.94±1.31) h, respectively, with no significant difference(P>0.05). There were no complications such as vascular nerve injury and fracture in experimental group, 2 cases of axillary nerve injury and 1 case of humeral head fracture in control group. Constant scores of shoulder joint between experimental group and control group were (92.34±5.62) points and (90.91±4.73) points, respectively, with no significant difference (P>0.05).

Conclusion: For patients with irreducible subcoracoid dislocation of the shoulder joint with Hill-Sacks injury, the countertraction method under anesthesia of the shoulder joint cavity achieved a higher success rate and few complications.
KEY WORDS  Anterior dislocation of the shoulder  Subcoracoid dislocation  Hill-sachs lesion  Countertraction method  Hippocrates
 
引用本文,请按以下格式著录参考文献:
中文格式:张如意,云才,杨涛,张易,朱建华,刘峰,张立超,苏鹏.两种方法整复合并Hill-Sacks损伤的难复性肩关节喙突下脱位[J].中国骨伤,2022,35(12):1115~1120
英文格式:ZHANG Ru-yi,YUN Cai,YANG Tao,ZHANG Yi,ZHU Jian-hua,LIU Feng,ZHANG Li-chao,and SU Peng.Countertraction method for reduction of irreducible subcoracoid dislocation of the shoulder joint with Hill-Sacks lesion[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(12):1115~1120
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