改良McLaughlin术治疗陈旧性未复位肩关节后脱位的临床研究

发布时间：2017-12-28 05:32

本文关键词：改良McLaughlin术治疗陈旧性未复位肩关节后脱位的临床研究　出处：《浙江大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的回顾分析接受改良McLaughlin手术治疗的陈旧性肩关节后脱位患者的临床转归以及影像学表现,提高对肩关节后脱位治疗的认识,并为临床治疗肩关节后脱位提供依据。方法回顾收集浙江大学医学院附属第二医院骨科2014年9月至2016年2月收治的4例陈旧性肩关节后脱位患者的病史资料和检查资料。该4例患者均为男性；年龄为38-42周岁,平均(39.5±2.4)岁；其中3例损伤原因为创伤后,1例为癫痫发作后；损伤的部位3例为右侧肩关节,1例为左侧肩关节；患者受伤至手术时间为3-53周,平均(23.5±23.6)周。该4例患者手术均由我院骨科主任医师主刀。患者于术前和术后随访时均接受影像学检查以及临床功能评估,末次随访时记录肩关节Constant-Murley功能评分。数据汇总制成图表后,进行统计学分析。结果患者随访调查时间1-18个月,平均(7.5±7)月,患者至随访结束时均未出现脱位复发。末次随访时,4例患者肩关节的前举活动度为95-175度,平均(138.8±33.0)度;外展的活动度为120-155度,平均(136.3±16.5);外旋的活动度为30-55度,平均(46.3±11.1)度；内旋的活动度为25-40度,平均(29.8±6.9)度。4例患者行改良McLaughlin手术前Constant肩关节功能评分为29-46分,平均(37.8±7.4)；末次随访时评分为72-88分,平均(81.8±7.4)分,较术前明显提高,差异显著(P0.05)。结论针对陈旧性肩关节后脱位,采用改良McLaughlin方法,可取得较好的临床疗效及病人满意度,术后早期随访患者功能良好。
[Abstract]:Objective To retrospectively analyze the clinical outcomes and imaging findings of patients with old posterior dislocation of shoulder after modified McLaughlin operation, and to improve the understanding of the treatment of posterior dislocation of shoulder joint, and provide evidence for clinical treatment of posterior dislocation of shoulder joint. Methods the history and data of 4 old patients with posterior dislocation of shoulder treated in Department of orthopedics, Second Hospital Affiliated to Zhejiang University medical school from September 2014 to February 2016 were retrospectively reviewed. The 4 patients were male; age 38-42 years of age, the average (39.5 + 2.4) years old; cause of injury in 3 cases after trauma, 1 cases of epilepsy; the site of injury 3 cases of right shoulder joint, 1 cases of left shoulder; the time from injury to operation was 3-53 weeks, average (23.5 + 23.6) weeks. The 4 patients were operated by our hospital department of orthopedics director surgeon. The patients received imaging examination and clinical function assessment before and after the follow-up, and the Constant-Murley function score of shoulder joint was recorded at the last follow-up. A statistical analysis was carried out after a summary of the data was made into a chart. Results the patients were followed up for 1-18 months, with an average of (7.5 + 7) months, and there was no recurrence of dislocation at the end of the follow-up. At the last follow-up, 4 patients had a shoulder activity range of 95-175 degrees, with an average of (138.8 + 33) degrees; the activity range of abduction was 120-155 degrees, with an average of (136.3 + 16.5); the activity of external rotation was 30-55 degrees, with an average of (46.3 + 11.1) degrees; the activity of internal rotation was 25-40 degrees, and the average level was (25-40 + 25-40). The Constant shoulder function score of 4 patients underwent modified McLaughlin operation was 29-46 points, averaging (37.8 + 7.4). The last follow-up time was 72-88 points, with an average of (81.8 + 7.4) points, which was significantly improved compared with that before operation (P0.05). Conclusion for the old patients with posterior dislocation of the shoulder, the improved McLaughlin method can achieve better clinical efficacy and patient satisfaction.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.4

【相似文献】