本文關(guān)鍵詞：改良McLaughlin術(shù)治療陳舊性未復(fù)位肩關(guān)節(jié)后脫位的臨床研究　出處：《浙江大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 肩關(guān)節(jié)后脫位 肱骨頭缺損 陳舊性未復(fù)位脫位 McLaughlin手術(shù)

【摘要】：目的回顧分析接受改良McLaughlin手術(shù)治療的陳舊性肩關(guān)節(jié)后脫位患者的臨床轉(zhuǎn)歸以及影像學(xué)表現(xiàn),提高對(duì)肩關(guān)節(jié)后脫位治療的認(rèn)識(shí),并為臨床治療肩關(guān)節(jié)后脫位提供依據(jù)。方法回顧收集浙江大學(xué)醫(yī)學(xué)院附屬第二醫(yī)院骨科2014年9月至2016年2月收治的4例陳舊性肩關(guān)節(jié)后脫位患者的病史資料和檢查資料。該4例患者均為男性；年齡為38-42周歲,平均(39.5±2.4)歲；其中3例損傷原因?yàn)閯?chuàng)傷后,1例為癲癇發(fā)作后；損傷的部位3例為右側(cè)肩關(guān)節(jié),1例為左側(cè)肩關(guān)節(jié)；患者受傷至手術(shù)時(shí)間為3-53周,平均(23.5±23.6)周。該4例患者手術(shù)均由我院骨科主任醫(yī)師主刀�；颊哂谛g(shù)前和術(shù)后隨訪時(shí)均接受影像學(xué)檢查以及臨床功能評(píng)估,末次隨訪時(shí)記錄肩關(guān)節(jié)Constant-Murley功能評(píng)分。數(shù)據(jù)匯總制成圖表后,進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果患者隨訪調(diào)查時(shí)間1-18個(gè)月,平均(7.5±7)月,患者至隨訪結(jié)束時(shí)均未出現(xiàn)脫位復(fù)發(fā)。末次隨訪時(shí),4例患者肩關(guān)節(jié)的前舉活動(dòng)度為95-175度,平均(138.8±33.0)度;外展的活動(dòng)度為120-155度,平均(136.3±16.5);外旋的活動(dòng)度為30-55度,平均(46.3±11.1)度；內(nèi)旋的活動(dòng)度為25-40度,平均(29.8±6.9)度。4例患者行改良McLaughlin手術(shù)前Constant肩關(guān)節(jié)功能評(píng)分為29-46分,平均(37.8±7.4)；末次隨訪時(shí)評(píng)分為72-88分,平均(81.8±7.4)分,較術(shù)前明顯提高,差異顯著(P0.05)。結(jié)論針對(duì)陳舊性肩關(guān)節(jié)后脫位,采用改良McLaughlin方法,可取得較好的臨床療效及病人滿意度,術(shù)后早期隨訪患者功能良好。
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R687.4

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