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[慢性肩关节不稳行关节盂唇重建术后的感觉运动功能缺损。一项临床实验研究]

[Sensorimotor deficit after capsulolabral reconstruction in chronic instability of the shoulder. A clinical experimental study].

作者信息

Fremerey R, Freitag N, Bosch U, Lobenhoffer P, Wippermann B

机构信息

Unfallchirurgische Klinik, Klinikum Hildesheim.

出版信息

Unfallchirurg. 2005 Dec;108(12):1038-43. doi: 10.1007/s00113-005-1011-3.

Abstract

The anterior capsulolabral reconstruction technique described by Jobe is a modified Bankart repair. The capsular shift is performed in a horizontal direction via a subscapularis split approach avoiding any incision of the muscle. Of 43 patients with posttraumatic anterior shoulder instability treated by anterior capsulolabral reconstruction, 35 were examined after 3.7+/-1.4 years, and of these, 29 (82.9%) had no pain; the external rotation deficit was 4.1+/-2.9 degrees . The average Constant-Murley score was 92.4+/-7.1 and the average ASES score was 93.3+/-8.4. The reluxation rate was 7.7%. This technique was shown to provide good clinical results, but only 69% of the patients were able to return to their prior sporting activity level. This particular problem was addressed by investigating the joint proprioception and the activity of the periarticular muscles. The results confirmed a persistent deficit of proprioception as well as a pathologic EMG pattern after anterior capsulolabral reconstruction, which may explain the problem of incomplete restoration of the function of the shoulder joint.

摘要

乔布(Jobe)描述的前盂唇重建技术是一种改良的Bankart修复术。通过肩胛下肌劈开入路在水平方向进行关节囊移位,避免切开肌肉。在43例接受前盂唇重建治疗的创伤后前肩不稳患者中,35例在3.7±1.4年后接受检查,其中29例(82.9%)无疼痛;外旋缺失为4.1±2.9度。Constant-Murley平均评分为92.4±7.1,ASES平均评分为93.3±8.4。复发率为7.7%。该技术显示出良好的临床效果,但只有69%的患者能够恢复到之前的运动活动水平。通过研究关节本体感觉和关节周围肌肉的活动来解决这个特殊问题。结果证实,前盂唇重建后本体感觉持续缺失以及肌电图模式异常,这可能解释了肩关节功能恢复不完全的问题。

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