关节镜下Bankart联合SLAP损伤修复治疗复发性肩关节脱位的临床效果

发布时间：2018-05-09 20:43

本文选题：肩关节 + 关节镜　；参考：《军事医学》2017年02期

【摘要】：目的考察Bankart合并关节盂上唇从前至后部(superior labrum anterior to posterior,SLAP)损伤的复发性肩关节脱位患者采用关节镜修复手术治疗的临床效果。方法回顾分析2011年5月至2015年1月间因复发性肩关节脱位接受关节镜下Bankart联合SLAP损伤修复治疗的15例患者临床资料,将其作为试验组研究对象。患者平均年龄为24.2岁(16~38岁)。术中首先采用可吸收缝合锚钉对不稳定的SLAP损伤进行修复固定,之后再修复Bankart损伤。另选取15例单纯Bankart损伤接受关节镜修复治疗的复发性肩关节脱位患者作为对照组研究对象,患者的平均年龄为24.6(18~35岁)。在术前及末次随访时,采用视觉模拟评分(Visual Analogue Scale,VAS)、美国肩肘关节外科医师评分(American Shoulder and Elbow Surgeons,ASES)、Rowe肩关节评分以及肩关节活动度等对两组患者临床效果进行评估。结果试验组的平均随访时间为15个月(13~28个月),对照组为22个月(21~34个月)。试验组平均VAS评分从术前4.9降低到末次随访时的1.9,差异有统计学意义(P0.05);平均ASES评分和Rowe肩关节评分分别从术前的33.7和56.4提高到末次随访时91.8和94.1,差异均有统计学意义(P0.05);在VAS评分、ASES评分以及Rowe评分方面,术前及术后随访时,两组之间差异均无统计学意义(P0.05)。到末次随访时,两组所有病例均未再次出现复发性脱位,经物理检查亦未证实肩关节不稳存在。两组所有病例患侧肩关节的前屈、外展、内旋活动度均恢复至正常水平。结论关节镜下Bankart联合SLAP损伤可吸收缝合锚钉固定修复治疗复发性肩关节不稳临床效果满意,可有效重建患者肩关节稳定,改善肩关节功能。
[Abstract]:Objective to investigate the clinical effect of arthroscopic repair of recurrent dislocation of shoulder in patients with Bankart complicated with anterior and posterior superior labial superior labrum anterior to posteriorus injury. Methods from May 2011 to January 2015, the clinical data of 15 patients with recurrent shoulder dislocation treated by arthroscopic Bankart combined with SLAP injury repair were retrospectively analyzed. The average age of the patients was 24.2 years old and 16 to 38 years old. Absorbable suture anchors were first used to repair and fix unstable SLAP damage, and then Bankart damage was repaired. In addition, 15 patients with recurrent shoulder dislocation treated with arthroscopic repair of Bankart injury were selected as control group. The average age of the patients was 24. 6 and 1 835 years old. Before operation and at the last follow-up, the clinical effects of the two groups were evaluated by visual Analogue scale, American Shoulder and Elbow SurgeonsASESE Rowe shoulder joint score and shoulder motion. Results the mean follow-up time was 15 months (13 ~ 28 months) in the trial group and 21 ~ 34 months in the control group. The average VAS score of the trial group decreased from 4.9 before operation to 1.9 at the last follow-up, the difference was statistically significant (P 0.05), the average ASES score and the Rowe shoulder score increased from 33.7 and 56.4 before operation to 91.8 and 94.1 at the last follow-up, respectively. The difference was statistically significant. In terms of VAS score, ASES score and Rowe score, There was no significant difference between the two groups in preoperative and postoperative follow-up (P 0.05). At the last follow-up, no recurrent dislocation was found in all cases in both groups, and the shoulder joint instability was not confirmed by physical examination. The flexion, abduction and internal rotation of the shoulder joint of the two groups all returned to normal level. Conclusion arthroscopic Bankart combined with SLAP injury can be used to repair recurrent shoulder instability with absorbable suture anchor nail. It can effectively reconstruct the stability of shoulder joint and improve the function of shoulder joint.
【作者单位】：解放军309医院关节外科;解放军309医院创伤外科;解放军309医院门诊部;
【分类号】：R687.4

【相似文献】