Hill-Sachs损伤伴肩关节前方不稳的镜下手术治疗

发布时间：2018-08-03 09:21

【摘要】：[目的]探讨关节镜下盂唇修补联合Remplissage技术治疗伴有Hill-Sachs缺损的肩关节前方不稳的临床效果。[方法]2012年2月~2015年2月,60例复发性肩关节前方不稳接受关节镜下盂唇修补联合Remplissage手术治疗,其中男50例,女10例。手术时平均年龄29.30岁(21.50~45.80岁)。所有病例术前均证实存在前方盂唇损伤和明显的Hill-Sachs损伤,所有患者均由同一名医生施行关节镜下手术。[结果]术前肩关节不稳ISIS评分(3.80±0.70)分。平均随访时间16.6个月(12~23个月)。所有患者术后肩关节前屈上举、内旋及体侧外旋活动度与术前无明显差异。ASES评分由术前的(85.23±13.45)分增加至末次随访时的(94.11±8.16)分,差异具有统计学意义(P0.01)。Constant-Murley评分由术前的(95.92±3.41)分增加至末次随访时的(98.94±2.40)分,两时间点差异具有统计学意义(P0.01);Rowe评分由术前的(42.12±4.92)分增加至末次随访时的(88.11±3.55)分,差异具有统计学意义(P0.01)。末次随访未发现有再次肩关节脱位者。[结论]关节镜下前方关节囊修补联合Remplissage手术治疗合并Hill-Sachs缺损的临床效果满意,能够有效重建肩关节功能,避免术后再脱位的发生。
[Abstract]:[objective] to investigate the clinical effect of arthroscopic glenoid lip repair combined with Remplissage in the treatment of anterior shoulder instability with Hill-Sachs defect. [methods] from February 2012 to February 2015, 60 cases of recurrent anterior shoulder instability were treated by arthroscopic glenoid lip repair combined with Remplissage operation, including 50 males and 10 females. The mean age at the time of operation was 29.30 (21.50 / 45.80). All cases were proved to have anterior pelvic lip injury and obvious Hill-Sachs injury before operation. All patients were operated by the same doctor under arthroscopy. [results] preoperative ISIS score of shoulder instability was (3.80 卤0.70). The mean follow-up time was 16.6 months (12 ~ 23 months). There was no significant difference in the degree of internal rotation and lateral rotation between the two groups. The ASES score increased from (85.23 卤13.45) to (94.11 卤8.16) at the last follow-up. The difference was statistically significant (P0.01). The Constant-Murley score increased from (95.92 卤3.41) to (98.94 卤2.40) at the last follow-up, and the Rowe score increased from (42.12 卤4.92) to (88.11 卤3.55) at the last follow-up (P0.01). No further dislocation of the shoulder was found at the last follow-up. [conclusion] anterior articular capsule repair combined with Remplissage under arthroscopy is effective in the treatment of Hill-Sachs defect. It can effectively reconstruct shoulder function and avoid postoperative dislocation.
【作者单位】：厦门大学附属成功医院骨科解放军第174医院骨科;
【分类号】：R687.4

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