| 肩关节镜下双排与单排技术治疗IdebergⅠA型肩胛盂骨折的病例对照研究 |
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Received:January 26, 2025
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| 作者 | Author | 单位 | Unit | E-Mail |
| 沈哲源 |
SHEN Zhe-yuan |
湖州师范学院附属第一医院 湖州市第一人民医院骨科, 浙江 湖州 313000
湖州市骨性关节炎早期诊断与治疗研究重点实验室, 浙江 湖州 313000 |
Department of Orthopaedics, the First Affiliated Hospital of Huzhou Normal University, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
Huzhou Key Laboratory for Early Diagnosis and Treatment of Osteoarthritis, Huzhou 313000, Zhejiang, China |
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| 吴荣 |
WU Rong |
湖州师范学院附属第一医院 湖州市第一人民医院骨科, 浙江 湖州 313000
湖州市骨性关节炎早期诊断与治疗研究重点实验室, 浙江 湖州 313000 |
Department of Orthopaedics, the First Affiliated Hospital of Huzhou Normal University, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
Huzhou Key Laboratory for Early Diagnosis and Treatment of Osteoarthritis, Huzhou 313000, Zhejiang, China |
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| 彭巧英 |
PENG Qiao-ying |
湖州师范学院附属第一医院 湖州市第一人民医院骨科, 浙江 湖州 313000 |
Department of Orthopaedics, the First Affiliated Hospital of Huzhou Normal University, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China |
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| 李恒 |
LI Heng |
湖州师范学院附属第一医院 湖州市第一人民医院骨科, 浙江 湖州 313000
湖州市骨性关节炎早期诊断与治疗研究重点实验室, 浙江 湖州 313000 |
Department of Orthopaedics, the First Affiliated Hospital of Huzhou Normal University, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
Huzhou Key Laboratory for Early Diagnosis and Treatment of Osteoarthritis, Huzhou 313000, Zhejiang, China |
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| 郭松华 |
GUO Song-hua |
湖州师范学院附属第一医院 湖州市第一人民医院骨科, 浙江 湖州 313000
湖州市骨性关节炎早期诊断与治疗研究重点实验室, 浙江 湖州 313000 |
Department of Orthopaedics, the First Affiliated Hospital of Huzhou Normal University, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
Huzhou Key Laboratory for Early Diagnosis and Treatment of Osteoarthritis, Huzhou 313000, Zhejiang, China |
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| 张占丰 |
ZHANG Zhan-feng |
湖州师范学院附属第一医院 湖州市第一人民医院骨科, 浙江 湖州 313000
湖州市骨性关节炎早期诊断与治疗研究重点实验室, 浙江 湖州 313000 |
Department of Orthopaedics, the First Affiliated Hospital of Huzhou Normal University, the First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
Huzhou Key Laboratory for Early Diagnosis and Treatment of Osteoarthritis, Huzhou 313000, Zhejiang, China |
335980557@qq.com |
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| 期刊信息：《中国骨伤》2025年38卷，第3期，第223-230页 |
| DOI：10.12200/j.issn.1003-0034.20240947 |
| 基金项目:浙江省基础公益研究计划项目(编号:LTGD24H060001);浙江省医药卫生科技计划项目(编号:2024KY1649) |
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目的: 比较关节镜下双排固定与单排固定技术治疗IdebergⅠA型肩胛盂骨折的临床疗效。
方法: 自2018年6月至2022年12月选取肩关节镜治疗的26例IdebergⅠA型肩胛盂骨折患者,根据骨折块固定方式分为单排锚钉组和双排锚钉组。单排组12例,男7例,女5例;年龄25~53(38.42±9.61)岁;外伤至手术时间2~7(4.75±1.82) d。双排组14例,男10例,女4例;年龄21~53(37.36±10.19)岁;外伤至手术时间1~8(4.21±2.01) d。比较两组术前和术后1年肩关节前屈上举、外展、体侧外旋活动度变化,及Constant-Murley肩关节功能评分、Rowe评分情况。比较两组术前骨块占肩盂面积的百分比及末次随访时骨缺损占肩盂面积的百分比。
结果: 所有患者获得随访,单排组随访时间12~15(13.08±1.17)个月,双排组随访时间12~15(13.29±1.07)个月,两组比较差异无统计学意义(P>0.05)。单排组术前和术后1年前屈上举、外展、体侧外旋分别为(86.67±6.62)°、(79.50±5.68)°、(38.17±1.70)°和(162.50±4.52)°、(169.17±3.35)°、(50.67±10.20)°;双排组分别为(84.14±5.48)°、(81.71±5.20)°、(39.29±3.63)°和(162.29±5.53)°、(167.14±3.61)°、(56.93±9.56)°;两组术前和术后1年比较,差异有统计学意义(P<0.05);两组间比较,差异无统计学意义(P>0.05)。单排组术前和术后1年Constant-Murley评分及Rowe评分分别为(55.42±3.75)、(43.75±18.49)分和(94.83±2.21)、(95.42±4.50)分;双排组分别为(54.50±7.88)、(41.79±18.25)分和(94.36±4.73)、(95.00±4.80)分;两组术前和术后1年Constant-Murley评分及Rowe评分比较,差异无统计学意义(P>0.05)。两组术前骨块占肩盂面积百分比比较,差异无统计学意义(P>0.05);术后1年,单排组骨缺损占肩盂面积百分比(4.42±1.51)%与双排组(2.71±1.44)%比较,差异有统计学意义(P<0.05)。
结论: 单排和双排固定技术治疗IdebergⅠA型肩胛盂骨折,均可获得满意的功能恢复。但双排固定在减少骨折块的骨吸收方面更具优势。 |
| [关键词]:骨性Bankart损伤 肩关节镜技术 缝合锚 双滑轮技术 |
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| A case-control study of shoulder arthroscopic double row and single row technique for the treatment of Ideberg type ⅠA scapular glenoid fracture |
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Abstract:
Objective To compare clinical effect of arthroscopic double row fixation and single row fixation in treating Ideberg typeⅠA scapular glenoid fracture.
Methods From June 2018 to December 2022,26 patients with Ideberg typeⅠA scapular glenoid fracture treated with shoulder arthroscopy were divided into single-row anchor group and double-row anchor group according to the fixation method of fracture block. There were 12 patients in single-row anchor group,including 7 males and 5 females,aged from 25 to 53 years old with an average of (38.42±9.61) years old;the time from injury to operation ranged from 2 to 7 days with an average of (4.75±1.82) days. There were 14 patients in double-row anchor group,including 10 males and 4 females,aged from 21to 53 years old with an average of (37.36±10.19) years old;the time from injury to operation ranged from 1 to 8 days with an average of (4.21±2.01) days. The changes of shoulder joint flexion,abduction,lateral lateral rotation,Constant-Murley shoulder function score and Rowe scores were compared between two groups before operation and 1 year after operation. The percentage of bone mass in pelvis area before operation and the percentage of bone defect in pelvis area at the latest follow-up were compared between two groups.
Results All patients were followed up for 12 to 15 months with an average of (13.08±1.17) months in single-row anchor group and 12 to 15 months with an average of (13.29±1.07) months in double-row anchor group,with no statistical significance between two groups (P>0.05). The results of anterior flexion,abduction and lateral lateral rotation in single-row anchor group were(86.67±6.62) °,(79.50±5.68) °,(38.17±1.70) ° before operation,and (162.50±4.52)°,(169.17±3.35)°,(50.67±10.20)° at 1 year after operation; while in double-row anchor group were (84.14±5.48) °,(81.71±5.20) °,(39.29±3.63) ° before operation and (162.29 ±5.53) °,(167.14±3.61) °,(56.93±9.56) ° at 1 year after operation;the difference between two groups before operation and 1 year after operation was statistically significant (P<0.05). There were no significant difference between two groups (P>0.05). Constant-Murley scores and Rowe scores in single-row anchor group were (55.42±3.75),(43.75±18.49) before operation and (94.83±2.21),(95.42±4.50) at 1 year after operation,respectively;while in double-row anchor group were (54.50±7.88),(41.79±18.25) before operation and (94.36±4.73),(95.00±4.80) at 1 year after operation;there was no significant difference in Constant-Murley score and Rowe score between two groups before operation and 1 year after operation (P>0.05). There was significant difference in the percentage of bone mass in pelvis area between two groups before operation (P>0.05). There was no significant difference in the percentage of bone defect in the shoulder area between single-row anchor group(4.42±1.51)% and double-row anchor group (2.71±1.44)% at 1 year after operation (P<0.05).
Conclusion Both single and double row fixation techniques for the treatment of Ideberg typeⅠA scapular glenoid fracture could receive satisfactory functional recovery. However,double-row fixation has more advantages in reducing bone resorption of fracture mass. |
| KEYWORDS:Bony Bankart Shoulder arthroscopy Suture anchor Double pulley technique |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 沈哲源,吴荣,彭巧英,李恒,郭松华,张占丰.肩关节镜下双排与单排技术治疗IdebergⅠA型肩胛盂骨折的病例对照研究[J].中国骨伤,2025,38(3):223~230 |
| 英文格式: | SHEN Zhe-yuan,WU Rong,PENG Qiao-ying,LI Heng,GUO Song-hua,ZHANG Zhan-feng.A case-control study of shoulder arthroscopic double row and single row technique for the treatment of Ideberg type ⅠA scapular glenoid fracture[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(3):223~230 |
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