摘要
目的探讨肩关节镜下单排锚钉技术治疗急性骨性Bankart损伤的临床疗效。方法回顾性分析我院2015年3月至2016年9月收治的12例急性骨性Bankart损伤病人的临床资料。所有病人均为初次肩关节前脱位造成的急性骨性Bankart损伤。其中男9例,女3例,平均年龄为38.8岁。Bigliani分型:Ⅰ型8例,Ⅱ型4例。均采用肩关节镜下单排锚钉缝合修复,锚钉数量为3～4颗。通过影像学资料评估骨折愈合情况;临床检查肩关节恐惧试验评估肩关节稳定性;比较病人术前术后的改良版肩功能Rowe评分和疼痛视觉模拟量表(visual analogue scale, VAS)评分。收集病人末次随访时对手术结果的整体满意情况。结果 12例病人平均随访时间为15.3个月。所有病人骨折愈合良好,无复发脱位出现,肩关节恐惧试验转为阴性,无半脱位出现。关节活动度较术前明显改善。术后Rowe评分和VAS评分分别为(96.170±3.215)分、(0.580±0.793)分,较术前的(54.670±12.702)分、(3.670±1.371)分显著改善,差异均有统计学意义(P均<0.05)。末次随访时,12例病人中,9例(75.0%)表示非常满意,2例(16.7%)满意,1例(8.3%)部分满意。结论肩关节镜下单排锚钉缝合治疗初次肩关节前脱位造成的急性骨性Bankart损伤可以取得优异的临床疗效。
Objective To explore the clinical effect of single-row anchor technique under the shoulder arthroscopy in the treatment of acute bony Bankart lesion. Methods From March 2015 to September 2016, 12 patients with acute bony Bankart lesion with primary anterior shoulder dislocation treated in our hospital were reviewed. There were 9 males and 3 females with the average age of 38.8 years. There were 8 cases of Bigliani type Ⅰ and 4 cases of Bigliani type Ⅱ. All patients were treated by single-row suture anchor technique. The number of suture anchors in surgery was 3 or 4. Fracture healing was evaluated by imaging data. Shoulder apprehension test was used to evaluate the shoulder joint stability. The modified Rowe score for shoulder function and visual analogue scale(VAS) score were compared before and after operation. The overall satisfaction of the patients with the surgical results at the last follow-up was collected. Results The average follow-up time was 15.3 months. All the fractures healed well, redislocation did not recur, and the apprehension sign on the shoulders was negative, and subluxation did not occur. The range of motion was significantly improved. The preoperative Rowe score and VAS score for instability were 54.670±12.702 and 3.670±1.371 respectively, and the recently postoperative Rowe score and VAS score were 96.170±3.215 and 0.580±0.793,respectively. There was significant difference in Rowe score and VAS score for instability before and after operation(P<0.05). At the last follow-up, 9 patients were very satisfied(75.0%), 2 patients satisfied(16.7%)and 1 partially satisfied(8.3%). Conclusion The single-row suture anchor technique under the shoulder arthroscopy can achieve excellent therapeutic effect in the treatment of acute bony Bankart lesion with primary anterior shoulder dislocation.
作者
刘文科
聂茂
尹良军
万海民
王卓群
郑繁
吴亚鸿
舒涵
LIU Wen-ke;NIE Mao;YIN Liang-jun;WAN Hai-min;WANG Zhuo-qun;ZHENG Fan;WU Ya-hong;SHU Han(Department of Orthopaedics,the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010,China)
出处
《骨科》
CAS
2019年第3期179-183,共5页
ORTHOPAEDICS
基金
国家自然科学基金(81501867)
