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[索温斯基喙突成形术治疗复发性肩关节脱位的价值]

[The value of Sowinski coracoid-plasty for recurrent dislocation of the shoulder].

作者信息

Zwierzchowski H, Fabiś J

机构信息

Katedry i Kliniki Ortopedii AM w Lodzi.

出版信息

Chir Narzadow Ruchu Ortop Pol. 1991;56(4-6):100-3.

PMID:1369895
Abstract

The value of Sowiński coracoplasty for recurrent, trauma related dislocation of the shoulder was evaluated on the basis of multidirectional clinical, Xray, CT and ultrasound examinations in 15 patients operated on between 18 and 40 years of age. Good results were achieved in 14 cases after 2-14 years follow up. In one case of epileptic patient 4.5 years after surgery traumatic dislocation of the shoulder occurred with a fracture of incorporated bony graft. The authors have proved the coracoplasty performed to be efficient in preventing recurrent dislocation of the shoulder by means of creating new biomedical conditions around the joint. The bony graft by elongation of the coracoid process of ca 35 mm and change in its alignment imposes strong mechanical support for the head of the humerus and indirectly makes the acetabulum deeper. The graft located above anterior rim of the acetabulum increases the tension of subscapular muscle and stabilizes the capsule thus aiding to the stability of the joint. In 4 cases some adhesions between the graft and subscapularis muscle have slightly restricted external sotation of the shoulder.

摘要

在15例年龄在18至40岁之间接受手术的患者中,通过多方向临床、X线、CT和超声检查,评估了索温斯基喙突成形术对复发性、创伤性肩关节脱位的治疗价值。经过2至14年的随访,14例患者取得了良好的效果。在1例癫痫患者中,术后4.5年发生了外伤性肩关节脱位,并伴有植入骨移植块骨折。作者证明,通过在关节周围创造新的生物医学条件,所施行的喙突成形术在预防复发性肩关节脱位方面是有效的。通过将喙突延长约35毫米并改变其对线,骨移植块为肱骨头提供了强大的机械支撑,并间接使关节盂更深。位于关节盂前缘上方的移植块增加了肩胛下肌的张力,稳定了关节囊,从而有助于关节的稳定性。在4例患者中,移植块与肩胛下肌之间的一些粘连轻微限制了肩关节的外旋。

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