Mizuno Naoko, Yoneda Minoru, Nakagawa Shigeto, Hayashida Kenji
Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibaharacho, Toyonaka-shi, 560-8565, Osaka, Japan.
Arthroscopy and Sports Medicine Center, Nakanoshima Iwaki Hospital, 3-2-9 Fukushima, Fukushima-ku, Osaka-shi, 553-0003, Osaka, Japan.
Int Orthop. 2016 Jan;40(1):81-6. doi: 10.1007/s00264-015-2864-x. Epub 2015 Jul 8.
We evaluated the pathologies of anterior capsular mechanism in older patients with recurrent anterior shoulder dislocation in the absence of full-thickness rotator cuff tears.
Three hundred and ninety-five shoulders with recurrent anterior shoulder dislocation were assessed. The patients were divided into three groups by the age at the first dislocation and the surgical treatment: group A (onset and treatment were at an age over 40 years), group B (onset was at an age under 40 years and treatment was at an age over 40 years) and group C (onset and treatment were at an age under 40 years). Groups A, B and C involved nine, 31 and 355 shoulders, respectively.
The prevalence of an isolated Bankart lesion was 81.7 % in group C, 33.3 % in group A and 64.5 % in group B, and each of A and B was significantly lower than group C. The prevalence of an isolated capsular tear was 3.1 % in group C, while it was 33.3 % in group A, which was significantly higher.
The prevalence of an isolated Bankart lesion was low and the prevalence of a capsular tear was high in older patients. We should keep in mind the existence of a capsular tear in older patients and examine the whole anterior capsular mechanism meticulously.
我们评估了在没有全层肩袖撕裂的复发性肩关节前脱位老年患者中前囊机制的病理情况。
对395例复发性肩关节前脱位的患者进行评估。根据首次脱位时的年龄和手术治疗情况将患者分为三组：A组（发病和治疗年龄均超过40岁）、B组（发病年龄低于40岁且治疗年龄超过40岁）和C组（发病和治疗年龄均低于40岁）。A、B、C组分别涉及9例、31例和355例肩部病例。
单纯Bankart损伤的发生率在C组为81.7%，在A组为33.3%，在B组为64.5%，A组和B组均显著低于C组。单纯囊撕裂的发生率在C组为3.1%，而在A组为33.3%，显著更高。
老年患者中单纯Bankart损伤的发生率低，而囊撕裂的发生率高。我们应牢记老年患者存在囊撕裂的情况，并仔细检查整个前囊机制。
