Ikemoto Roberto Yukio, Murachovisky Joel, Nascimento Luis Gustavo Prata, Bueno Rogério Serpone, Almeida Luiz Henrique Oliveira, Strose Eric, Helmer Fábio Fernando
Head of the Orthopedics Service, Hospital Ipiranga, and Shoulder and Elbow Group, ABC School of Medicine, São Paulo, SP, Brazil.
Attending Physician in the Shoulder and Elbow Group, ABC School of Medicine, and Hospital Ipiranga, São Paulo, SP, Brazil.
Rev Bras Ortop. 2015 Dec 6;46(5):553-60. doi: 10.1016/S2255-4971(15)30411-0. eCollection 2011 Sep-Oct.
Evaluate the results from the Latarjet procedure in patients with anterior recurrent dislocation of the shoulder who present bone loss of the glenoid cavity greater than 25%.
Twenty six male patients underwent the Latarjet procedure, The bone loss was evaluated by means of radiography using the Bernageau view and by means of CAT scan. The patients were evaluated with regard to range of motion, using the Rowe and UCLA scales, before and after the operation, and by radiographs to assess the presence of arthrosis, position and consolidation of the graft and positioning of the screws. Statistical analysis was used to assess whether there was any relationship between the number of episodes of dislocation and the presence of arthrosis, , and any relationship between arthrosis and limitations on lateral rotation. Differences in range of motion between the operated and unaffected sides and in the UCLA and Rowe scale.
The means for elevation and lateral rotation were statistically poorer on the operated side. The UCLA and Rowe scale showed that there was a statistically significant improvement in the clinical-functional results (P < 0.001 for both). There was a relationship between the number of episodes of dislocation and the presence of arthrosis, We also did not observe any correlation between limitations on lateral rotation and arthrosis.
The Latarjet procedure is an efficient method for cases of severe erosion of the glenoid margin.
评估拉塔热(Latarjet)手术对肩关节前复发性脱位且关节盂骨丢失超过25%患者的治疗效果。
26例男性患者接受了拉塔热手术,通过使用贝纳热(Bernageau)位X线摄影及计算机断层扫描(CAT)评估骨丢失情况。在手术前后,使用罗(Rowe)氏和加州大学洛杉矶分校(UCLA)评分量表评估患者的活动范围,并通过X线片评估关节病的存在、移植物的位置和愈合情况以及螺钉的定位。采用统计分析评估脱位发作次数与关节病存在之间是否存在任何关系,以及关节病与外旋受限之间是否存在任何关系。比较手术侧与未受影响侧的活动范围差异以及UCLA和Rowe评分量表的差异。
手术侧的抬高和外旋平均值在统计学上较差。UCLA和Rowe评分量表显示临床功能结果有统计学意义的改善(两者P均<0.001)。脱位发作次数与关节病的存在之间存在关联,我们也未观察到外旋受限与关节病之间存在任何相关性。
对于关节盂边缘严重侵蚀的病例,拉塔热手术是一种有效的方法。