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关节镜下切除棒球运动员肩部有症状的贝内特损伤:关节镜下贝内特成形术

Arthroscopic removal of symptomatic Bennett lesions in the shoulders of baseball players: arthroscopic Bennett-plasty.

作者信息

Yoneda Minoru, Nakagawa Shigeto, Hayashida Kenji, Fukushima Sunao, Wakitani Shigeyuki

机构信息

Shoulder and Sports Medicine Service, Osaka Kosei-nenkin Hospital, Osaka, Japan.

出版信息

Am J Sports Med. 2002 Sep-Oct;30(5):728-36. doi: 10.1177/03635465020300051701.

Abstract

BACKGROUND

Bennett lesions are often observed in throwing athletes, and, although usually asymptomatic, they can sometimes become painful and disturb an athlete's throwing ability. Because it is clinically difficult to determine whether a Bennett lesion is symptomatic or whether pain is from another lesion, the outcome of surgical treatment is variable.

HYPOTHESIS

Arthroscopic resection of Bennett lesions diagnosed according to our criteria and arthroscopic treatment of associated lesions performed simultaneously were effective for treatment of baseball players with symptomatic Bennett lesions.

STUDY DESIGN

Prospective cohort study.

METHODS

The following criteria for diagnosis of a symptomatic Bennett lesion were used to identify 16 baseball players who later underwent arthroscopic removal of the symptomatic Bennett lesion (arthroscopic Bennett-plasty): 1) detection of a bony spur at the posterior glenoid rim on radiographs; 2) posterior shoulder pain during throwing, especially in the follow-through phase; 3) tenderness at the posteroinferior aspect of the glenohumeral joint; and 4) relief of pain by injection of local anesthesia.

RESULTS

After a minimum follow-up of 1 year, there was no tenderness at the posteroinferior aspect of the glenohumeral joint in any of the patients. Throwing pain disappeared in 10 shoulders and was mitigated in 6 shoulders. Eleven patients returned to baseball at their previous level of competition.

CONCLUSIONS

Accurate diagnosis and minimally invasive arthroscopic surgery are important for appropriate treatment of baseball players with symptomatic Bennett lesions.

摘要

背景

贝内特损伤常在投掷运动员中观察到,尽管通常无症状,但有时会变得疼痛并影响运动员的投掷能力。由于临床上难以确定贝内特损伤是否有症状,或者疼痛是否来自其他损伤,手术治疗的结果存在差异。

假设

根据我们的标准诊断的贝内特损伤的关节镜下切除以及同时进行的相关损伤的关节镜治疗,对于治疗有症状的贝内特损伤的棒球运动员是有效的。

研究设计

前瞻性队列研究。

方法

使用以下有症状的贝内特损伤的诊断标准来确定16名后来接受了有症状的贝内特损伤关节镜下切除(关节镜下贝内特成形术)的棒球运动员:1)X线片上在肩胛盂后缘检测到骨赘;2)投掷时后肩部疼痛,尤其是在随挥阶段;3)肩肱关节后下方压痛;4)局部麻醉注射后疼痛缓解。

结果

在至少1年的随访后,所有患者的肩肱关节后下方均无压痛。10个肩部的投掷疼痛消失,6个肩部的疼痛减轻。11名患者恢复到之前的棒球比赛水平。

结论

准确诊断和微创关节镜手术对于有症状的贝内特损伤的棒球运动员的恰当治疗很重要。

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