Subramanian Kanthalu Narayanan, Channabasappa Eswarappa Deepak, Senthilnathan Ganesh Prajwal, Subramanian Muthukumar, Sellappan Rajesh
Velammal Medical College, Madurai, India.
Wrightington Hospital, Wigan, United Kingdom.
J Orthop. 2021 Apr 14;25:120-123. doi: 10.1016/j.jor.2021.03.016. eCollection 2021 May-Jun.
To study the intraoperative morphology of the glenoid labrum and capsule in recurrent shoulder dislocation and to study the relationship between the number of dislocations and the changes in the glenoid and labrum.
Over a period of 18 months, 108 patients with traumatic anterior dislocations were included in the study, of which 102 men and 6 women with mean age of 33.4yrs range from 18 to 45. The patients with bony bankart, other labral lesions, ligamentous laxity, SLAP tear were excluded from the study. All the patients underwent arthroscopic bankart repair. We have classified the morphology of labrum and capsule on their appearance intraoperatively. Labrum is named as Normal, Desiccated or Shredded and Capsule as Normal or Damaged.
Six varieties of appearances were observed. Namely, Normal capsule and Normal labrum (NN), Normal capsule and Desiccated labrum (ND), Normal capsule and Shredded labrum (NS), Damaged capsule and Normal labrum (DN), Damaged capsule and Desiccated labrum(DD), Damaged capsule and Shredded labrum(DS). Among them, DD (33.3%) and DS (29.6%) variety had highest number of dislocations suggesting the labrum and capsule lose normal anatomy with more recurrence of dislocations.
These findings support that reproducing normal anatomy after surgical repair is possible when the intervention is done sooner than later.
III.
研究复发性肩关节脱位时盂唇和关节囊的术中形态,并研究脱位次数与盂和盂唇变化之间的关系。
在18个月的时间里,108例创伤性前脱位患者纳入研究,其中男性102例,女性6例,平均年龄33.4岁,年龄范围为18至45岁。骨Bankart损伤、其他盂唇损伤、韧带松弛、SLAP损伤的患者被排除在研究之外。所有患者均接受关节镜下Bankart修复术。我们根据术中外观对盂唇和关节囊的形态进行了分类。盂唇分为正常、干燥或撕裂,关节囊分为正常或受损。
观察到六种外观类型。即,正常关节囊和正常盂唇(NN)、正常关节囊和干燥盂唇(ND)、正常关节囊和撕裂盂唇(NS)、受损关节囊和正常盂唇(DN)、受损关节囊和干燥盂唇(DD)、受损关节囊和撕裂盂唇(DS)。其中,DD(33.3%)和DS(29.6%)类型的脱位次数最多,表明随着脱位复发次数增加,盂唇和关节囊失去了正常解剖结构。
这些发现支持尽早进行手术修复,恢复正常解剖结构是可行的。
III级。