Aydin Ali, Usta Mustafa, Topal Murat, Uymur Erdem Yunus, Tuncer Kutsi, Karsan Orhan
Department of Orthopedics and Traumatology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
Department of Orthopedics and Traumatology, Sabuncuoglu Serefeddin State Hospital, Amasya, Turkey.
Eurasian J Med. 2012 Dec;44(3):157-62. doi: 10.5152/eajm.2012.37.
The purpose of this study was to compare the results of open Bankart repair versus those of modified Bristow operation in patients with recurrent anterior dislocations of the shoulder, the last of which was caused by a minor trauma.
This study included 38 patients (34 (89.5%) male and 4 (10.5%) female) who presented recurrent dislocation of the shoulders with capsular laxity and who underwent an open Bankart repair or a modified Bristow operation. The mean age of the patients was 29.6 years (range, 17-60 years). The mean follow-up period was 5.5 years (range, 35 months to 9 years). A total of 25 patients (65.8%) underwent an open Bankart repair, whereas 13 (34.2%) underwent a modified Bristow operation. The treatment results were assessed using the Rowe score for instability.
Of the 38 shoulders assessed, 24 (63.1%) were right shoulders and 14 (36.9%) were left shoulders. Furthermore, 26 (68.4%) were the dominant shoulders of the patients, and 12 (31.6%) were the non-dominant shoulders. The mean time from the first dislocation was 3.8 years (range, 10 months to 11 years). The age at which the first shoulder dislocation occurred was 20 years or younger in 7 cases (18.4%), 21-30 years in 22 cases (57.9%), 31-40 years in 6 cases (15.8%) and 41 or older in 3 cases (7.9%). The patients had experienced 4-10 recurrent dislocations in 15 cases (39.5%), 10-20 recurrent dislocations in 10 cases (26.3%) and 20 or more recurrent dislocations in 13 cases (34.2%). The mean Rowe score was 85.6 following open Bankart repair and 81.9 following modified Bristow. No significant difference was observed between these good and excellent Rowe scores following the open Bankart repair and the modified Bristow operation (p>0.05).
Proper patient selection for the open Bankart repair and the modified Bristow operation is crucial. When the proper patients have been selected for these procedures, both produce satisfactory results for the treatment of patients with capsular laxities.
本研究旨在比较开放性Bankart修复术与改良Bristow手术治疗复发性肩关节前脱位患者（最后一次脱位由轻度创伤引起）的效果。
本研究纳入38例复发性肩关节脱位伴关节囊松弛且接受开放性Bankart修复术或改良Bristow手术的患者（34例（89.5%）男性，4例（10.5%）女性）。患者平均年龄29.6岁（范围17 - 60岁）。平均随访时间5.5年（范围35个月至9年）。25例（65.8%）患者接受开放性Bankart修复术，13例（34.2%）接受改良Bristow手术。采用Rowe不稳定评分评估治疗效果。
在评估的38个肩关节中，24个（63.1%）为右肩，14个（36.9%）为左肩。此外，26个（68.4%）是患者的优势肩，12个（31.6%）是非优势肩。首次脱位后的平均时间为3.8年（范围10个月至11年）。首次肩关节脱位发生时年龄在20岁及以下的有7例（18.4%），21 - 30岁的有22例（57.9%），31 - 40岁的有6例（15.8%），41岁及以上的有3例（7.9%）。15例（39.5%）患者经历过4 - 10次复发性脱位，10例（26.3%）经历过10 - 20次复发性脱位，13例（34.2%）经历过20次及以上复发性脱位。开放性Bankart修复术后平均Rowe评分为85.6分，改良Bristow手术后平均Rowe评分为81.9分。开放性Bankart修复术和改良Bristow手术后这些优良的Rowe评分之间未观察到显著差异（p>0.05）。
正确选择开放性Bankart修复术和改良Bristow手术的患者至关重要。当为这些手术选择合适的患者时，两者对关节囊松弛患者的治疗均能产生满意的效果。
