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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Received:April 17, 2021
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作者 | Author | 单位 | Unit | 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34卷,第6期,第497-503页 |
DOI:10.12200/j.issn.1003-0034.2021.06.003 |
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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 |
KEYWORDS: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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