Ozbaydar Mehmet Uğur, Tonbul Murat, Altun Mehmet, Yalaman Okan
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Kliniği), Istanbul Okmeydani Training and Research Hospital, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2005;39(2):97-103.
We evaluated the functional results of treatment with the selective capsular shift technique in patients with recurrent post-traumatic anterior-inferior glenohumeral instability.
The study included 16 patients (15 males, 1 female; mean age 30 years; range 25 to 38 years) who underwent selective capsular shift operation for recurrent post-traumatic anterior-inferior glenohumeral instability. Dislocations occurred following severe (n=14) or mild (n=2) trauma. Preoperatively, the mean number of dislocations was 14 (range 4 to 45) and magnetic resonance imaging showed a Bankart lesion in all the patients and a Hill-Sachs lesion in 20%. The patients were evaluated according to the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and Rowe's scoring for Bankart repair. Preoperative and postoperative anteroposterior and axillary x-rays were obtained from all the patients. Range of motion was measured with a goniometer and manual muscle strength tests were performed. The mean follow-up was 41 months (range 21 to 74 months). Statistical analysis was made using the t-test.
The mean preoperative and postoperative ASES scores differed significantly (63.2 vs 95.8; p<0.05). The mean Rowe score was 92.5 (range 70 to 100). Strength of the infraspinatus, supraspinatus, and subscapularis muscles increased significantly (p<0.05). The results were excellent in 12 patients (75%), good in two patients (12.5%), and fair in two patients. Fifteen patients (93.8%) expressed satisfaction with the operation and results.
Addition of the selective capsular shift technique to the Bankart repair procedure improves stability and preserves the range of motion of the glenohumeral joint in patients with anterior-inferior glenohumeral instability accompanied by a Bankart lesion and capsular injury or laxity.
我们评估了选择性关节囊移位技术治疗创伤后复发性肩肱关节前下不稳患者的功能结果。
该研究纳入了16例患者（15例男性，1例女性；平均年龄30岁；范围25至38岁），这些患者因创伤后复发性肩肱关节前下不稳接受了选择性关节囊移位手术。脱位发生在严重创伤（n = 14）或轻度创伤（n = 2）之后。术前，脱位的平均次数为14次（范围4至45次），磁共振成像显示所有患者均有Bankart损伤，20%的患者有Hill-Sachs损伤。根据美国肩肘外科医师协会标准化肩部评估表（ASES）和Rowe对Bankart修复的评分对患者进行评估。所有患者均拍摄了术前和术后的前后位及腋位X线片。使用角度计测量活动范围，并进行手动肌力测试。平均随访时间为41个月（范围21至74个月）。采用t检验进行统计分析。
术前和术后ASES评分的平均值有显著差异（63.2对95.8；p<0.05）。Rowe评分的平均值为92.5（范围70至100）。冈下肌、冈上肌和肩胛下肌的力量显著增加（p<0.05）。12例患者（75%）结果为优，2例患者（12.5%）为良，2例患者为中。15例患者（93.8%）对手术和结果表示满意。
在Bankart修复手术中增加选择性关节囊移位技术可提高稳定性，并保留伴有Bankart损伤和关节囊损伤或松弛的肩肱关节前下不稳患者的活动范围。
