Savoie Felix H., Papendik Lew, Field Larry D., Jobe Christopher
Upper Extremity Service, Mississippi Sports Medicine and Orthopaedic Center (F.H.S., L.P., L.D.F.); the Department of Orthopaedic Surgery, the University of Mississippi School of Medicine (F.H.S.) Jackson, Mississippi; and the Department of Orthopaedic Surgery, Loma Linda Medical Center (C.J.), Loma Linda, California, U.S.A.
Arthroscopy. 2001 Mar;17(3):229-235. doi: 10.1053/jars.2001.21486.
Thirty-three patients with avulsions of the middle glenohumeral ligament repaired using arthroscopic techniques were evaluated to determine the mechanism of injury, physical examination findings, and efficiency of repair techniques in this patient cohort. Type of Study: In a retrospective consecutive case series, 33 patients with symptomatic anterior subluxation of the glenohumeral joint were found to have a history, physical examination, and diagnostic arthroscopy consistent with isolated avulsions of a type I middle glenohumeral ligament. METHODS: The mechanism of injury was either repetitive overhead activity (17 patients) or a forced hyperextension in neutral rotations (16 patients). Physical examination was positive for a load and shift (fulcrum) testing of the middle glenohumeral ligament and "Whipple" testing of the anterior supraspinatus tendon. Magnetic resonance imaging with or without gadolinium was positive for anterior labral tearing in all 20 patients in which the test was performed. RESULTS: Arthroscopic repair of the detached labrum resulted in decreased pain and improved function in all patients. Thirty-one of the patients were well satisfied, 1 was improved, and 1 was dissatisfied with the repair. CONCLUSIONS: Thirty-one of 33 patients graded as excellent, 1 good, and 1 poor in this study. Surgical repair of avulsions of the middle glenohumeral ligament provides satisfactory results in a majority of patients.
对33例采用关节镜技术修复肩肱中韧带撕脱伤的患者进行评估，以确定损伤机制、体格检查结果以及该患者群体中修复技术的有效性。研究类型：在一项回顾性连续病例系列研究中，33例有症状的肩肱关节前脱位患者经病史、体格检查及诊断性关节镜检查，发现符合Ⅰ型肩肱中韧带孤立性撕脱伤。方法：损伤机制为重复性过头活动（17例患者）或中立旋转位的强迫过伸（16例患者）。体格检查中，肩肱中韧带的负荷和移位（支点）试验以及冈上肌肌腱前部的“Whipple”试验呈阳性。在所有20例行该项检查的患者中，无论是否使用钆对比剂，磁共振成像均显示存在前盂唇撕裂。结果：关节镜下修复分离的盂唇后，所有患者的疼痛均减轻，功能均改善。31例患者对修复效果非常满意，1例有所改善，1例不满意。结论：本研究中33例患者，31例评为优秀，1例良好，1例差。肩肱中韧带撕脱伤的手术修复在大多数患者中可取得满意结果。
