摘要
目的探讨新型McLaughlin改良手术联合带线锚钉固定治疗肩关节后脱位的临床效果。方法回顾性分析2013年5月至2019年1月武警广东省总队医院收治的7例肩关节后脱位患者的临床资料。患者均采用新型McLaughlin改良手术治疗,即对经典McLaughlin手术进行少许简化,将上半部分肩胛下肌肌腱转位折叠填充肱骨头缺损,并以单排带线锚钉固定。观察术后切口愈合和并发症发生情况,评估术前和末次随访时Constant-Murley肩关节功能评分、美国肩肘外科医师协会(ASES)评分和加州大学洛杉矶分校(UCLA)评分,记录末次随访时肩关节活动度(ROM)。结果术后切口均Ⅰ期愈合,无复发脱位、内固定排异反应、神经损伤等早期并发症,影像学复查提示盂肱关节恢复正常对位关系。7例患者均获随访,随访时间14~60个月,平均随访时间25.4个月。末次随访时Constant-Murley肩关节功能评分、ASES评分、UCLA评分及肩关节ROM均较术前有所改善(P<0.05)。结论采用新型McLaughlin改良手术联合带线锚钉固定治疗肩关节后脱位,可有效改善患者肩关节功能,肩关节ROM恢复良好,临床效果满意。
Objective To investigate the clinical effect of a new modified McLaughlin surgery with fixation of suture anchors for patients with posterior dislocation of shoulder.Methods Clinical data of 7 patients with posterior dislocation of shoulder treated from May 2013 to January 2019 in Armed Police Force Guangdong Provincial Corps Hospital were retrospectively analyzed.All patients were performed a new modified McLaughlin procedure(simplicity for classic Mclaughlin procedure),that is,the top half of the subscapularis tendon was transposed,folded and filled into the humeral head defect with fixation of single-row suture anchors.Wound healing and postoperative complications were observed,Constant-Murley score of shoulder function,American Shoulder and Elbow Surgeons(ASES)score and score of University of California Los Angeles(UCLA)were evaluated before and after the surgery,range of motion(ROM)of shoulder was also recorded at the latest follow-up.Results Primary wound healing was found in all patients.No early complications such as recurrent dislocation of shoulder,rejection of internal fixators,nerve injury had happened after the surgery.Imaging re-examination results showed that the glenohumeral joint returned to normal alignment.All patients were followed up for 14 to 60 months,with an average of 25.4 months.At the latest follow-up,the mean Constant-Murley score of shoulder function,ASES score,UCLA score as well as ROM of shoulder were better than the preoperative ones.Conclusion For posterior dislocation of shoulder,new modified McLaughlin procedure with fixation of suture anchors can obtain satisfactory clinical effects due to its effective improvement of shoulder functions with good recovery of ROM of shoulder.
作者
李乔
李献成
陈泽
刘柱同
LI Qiao;LI Xiancheng;CHEN Ze;LIU Zhutong(Department of SurgeryⅡ,Armed Police Force Guangdong Provincial Corps Hospital,Guangzhou,Guangdong 510507,China)
出处
《中国骨科临床与基础研究杂志》
2020年第2期105-111,共7页
Chinese Orthopaedic Journal of Clinical and Basic Research
基金
广东医学科研基金(B2019145)。
