te Slaa R L, Wijffels M P J M, Brand R, Marti R K
Department of Orthopaedics and Traumatology, Reinier de Graaf Groep, Reinier de Graafweg 3, 2625 AD Delft, The Netherlands.
J Bone Joint Surg Br. 2004 Jan;86(1):58-64.
We have studied 105 patients with 107 acute, primary, dislocations of the glenohumeral joint seen between January 1, 1991 and July 1, 1994. The mean time of follow-up was 71 months (46 to 91). In 34% the injury occurred during a sports activity and in 28% at home. The bias toward sport was even greater in patients less than 40 years of age, and in men. In patients older than 40 years of age, and in women, the dislocation occurred more often at home. The overall probability of recurrence within four years was 26%. Age was the most significant prognostic factor in recurrence which took place in 64% of patients less than 20 years of age and in 6% of those older than 40 years. Statistically, there was no difference between the rates of recurrence in patients who were active in sport and those who were not. The mean Rowe score for the whole group was 87 (15 to 100). Associated fractures were found in 20 patients (19%) and nerve injuries in 22 (21%). None of those in whom a fracture of the greater tuberosity was seen subsequently suffered a recurrent dislocation. At follow-up we found that 36 patients (34%) had not returned to their former employment but in only 2% was this owing to the injured shoulder.
我们研究了1991年1月1日至1994年7月1日期间所见的105例患者的107例急性、原发性盂肱关节脱位。平均随访时间为71个月（46至91个月）。34%的损伤发生在体育活动期间，28%发生在家中。年龄小于40岁的患者以及男性中，运动导致损伤的比例更高。在年龄大于40岁的患者以及女性中，脱位更常发生在家中。四年内复发的总体概率为26%。年龄是复发最显著的预后因素，20岁以下患者中64%复发，40岁以上患者中6%复发。从统计学上看，积极参加运动的患者和不参加运动的患者复发率没有差异。整个组的平均Rowe评分为87分（15至100分）。20例患者（19%）发现有合并骨折，22例患者（21%）有神经损伤。随后发现有大结节骨折的患者中无一例复发性脱位。随访时我们发现，36例患者（34%）未恢复原工作，但其中仅2%是由于受伤的肩部所致。
