【摘要】：[目的]探討關(guān)節(jié)鏡下盂唇修補(bǔ)聯(lián)合Remplissage技術(shù)治療伴有Hill-Sachs缺損的肩關(guān)節(jié)前方不穩(wěn)的臨床效果。[方法]2012年2月~2015年2月,60例復(fù)發(fā)性肩關(guān)節(jié)前方不穩(wěn)接受關(guān)節(jié)鏡下盂唇修補(bǔ)聯(lián)合Remplissage手術(shù)治療,其中男50例,女10例。手術(shù)時(shí)平均年齡29.30歲(21.50~45.80歲)。所有病例術(shù)前均證實(shí)存在前方盂唇損傷和明顯的Hill-Sachs損傷,所有患者均由同一名醫(yī)生施行關(guān)節(jié)鏡下手術(shù)。[結(jié)果]術(shù)前肩關(guān)節(jié)不穩(wěn)ISIS評(píng)分(3.80±0.70)分。平均隨訪時(shí)間16.6個(gè)月(12~23個(gè)月)。所有患者術(shù)后肩關(guān)節(jié)前屈上舉、內(nèi)旋及體側(cè)外旋活動(dòng)度與術(shù)前無(wú)明顯差異。ASES評(píng)分由術(shù)前的(85.23±13.45)分增加至末次隨訪時(shí)的(94.11±8.16)分,差異具有統(tǒng)計(jì)學(xué)意義(P0.01)。Constant-Murley評(píng)分由術(shù)前的(95.92±3.41)分增加至末次隨訪時(shí)的(98.94±2.40)分,兩時(shí)間點(diǎn)差異具有統(tǒng)計(jì)學(xué)意義(P0.01);Rowe評(píng)分由術(shù)前的(42.12±4.92)分增加至末次隨訪時(shí)的(88.11±3.55)分,差異具有統(tǒng)計(jì)學(xué)意義(P0.01)。末次隨訪未發(fā)現(xiàn)有再次肩關(guān)節(jié)脫位者。[結(jié)論]關(guān)節(jié)鏡下前方關(guān)節(jié)囊修補(bǔ)聯(lián)合Remplissage手術(shù)治療合并Hill-Sachs缺損的臨床效果滿意,能夠有效重建肩關(guān)節(jié)功能,避免術(shù)后再脫位的發(fā)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 鹵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 鹵13.45) to (94.11 鹵8.16) at the last follow-up. The difference was statistically significant (P0.01). The Constant-Murley score increased from (95.92 鹵3.41) to (98.94 鹵2.40) at the last follow-up, and the Rowe score increased from (42.12 鹵4.92) to (88.11 鹵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.
【作者單位】： 廈門(mén)大學(xué)附屬成功醫(yī)院骨科解放軍第174醫(yī)院骨科;
【分類(lèi)號(hào)】：R687.4

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