Elganainy Abd Elrahman, El-Nour Mohammed Abou
Acta Orthop Belg. 2017 Sep;83(3):421-427.
Management of glenohumeral instability with large Hill-Sachs lesions remains controversial either to address or just grafting the glenoid rim defects. This study was done to investigate if open Latarjet is sufficient to prevent recurrent instability in patients with significant Hill-Sachs defects without addressing these lesions. In the period between October 2009 and November 2014 twenty three patients with shoulder instability and significant bone loss were treated by open Latarjet. All patients were followed up for a period ranged from 17 to 58 months (median ± SD : 30 ± 13.9).The mean preoperative Rowe score was significantly increased from 45.4 to 91.5 (p value <0,001). At the final follow up there was 17 patients with excellent result, 5 patients with good result and 2 patients with fair result. In conclusion, Latarjet provides a reliable and effective stabilization for anteroinferior glenohumeral instability with significant bone loss and engaging Hill-Sachs lesion.
对于伴有巨大Hill-Sachs损伤的盂肱关节不稳，无论是处理还是仅移植肩胛盂边缘缺损，其治疗方法仍存在争议。本研究旨在探讨开放Latarjet手术在不处理这些损伤的情况下，是否足以预防伴有明显Hill-Sachs缺损患者的复发性不稳。在2009年10月至2014年11月期间，对23例伴有肩部不稳和明显骨质丢失的患者进行了开放Latarjet手术治疗。所有患者均随访了17至58个月（中位数±标准差：30±13.9）。术前平均Rowe评分从45.4显著提高到91.5（p值<0.001）。在末次随访时，17例患者结果为优，5例为良，2例为可。总之，Latarjet手术为伴有明显骨质丢失和存在Hill-Sachs损伤的盂肱关节前下不稳提供了可靠且有效的稳定作用。
