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[肩关节前脱位Bristow-Latarjet手术生物力学研究进展]

[Research progress in biomechanics of Bristow-Latarjet procedure for anterior shoulder dislocation].

作者信息

Zhang Shuhan, Zhang Min, Shao Zhenxing, Cui Guoqing

机构信息

Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, 100191, P. R. China.

School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 May 15;37(5):518-525. doi: 10.7507/1002-1892.202210059.

Abstract

OBJECTIVE

To review the research progress of the biomechanical study of the Bristow-Latarjet procedure for anterior shoulder dislocation.

METHODS

The related biomechanical literature of Bristow-Latarjet procedure for anterior shoulder dislocation was extensively reviewed and summarized.

RESULTS

The current literature suggests that when performing Bristow-Latarjet procedure, care should be taken to fix the bone block edge flush with the glenoid in the sagittal plane in the direction where the rupture of the joint capsule occurs. If traditional screw fixation is used, a double-cortical screw fixation should be applied, while details such as screw material have less influence on the biomechanical characteristics. Cortical button fixation is slightly inferior to screws in terms of biomechanical performance. The most frequent site of postoperative bone resorption is the proximal-medial part of the bone block, and the cause of bone resorption at this site may be related to the stress shielding caused by the screw.

CONCLUSION

There is no detailed standardized guidance for bone block fixation. The optimal clinical treatment plan for different degrees of injury, the factors influencing postoperative bone healing and remodeling, and the postoperative osteoarticular surface pressure still need to be further clarified by high-quality biomechanical studies.

摘要

目的

回顾布里斯托-拉塔热(Bristow-Latarjet)手术治疗肩关节前脱位的生物力学研究进展。

方法

广泛查阅并总结布里斯托-拉塔热手术治疗肩关节前脱位的相关生物力学文献。

结果

当前文献表明,行布里斯托-拉塔热手术时,在关节囊破裂方向的矢状面应注意将骨块边缘与肩胛盂固定平齐。若采用传统螺钉固定,应使用双皮质螺钉固定,而螺钉材料等细节对生物力学特性影响较小。皮质纽扣固定在生物力学性能方面略逊于螺钉。术后骨吸收最常见的部位是骨块的近端内侧部分,该部位骨吸收的原因可能与螺钉导致的应力遮挡有关。

结论

骨块固定尚无详细的标准化指导。不同程度损伤的最佳临床治疗方案、影响术后骨愈合和重塑的因素以及术后骨关节面压力仍需高质量的生物力学研究进一步阐明。

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