Rowe C R, Patel D, Southmayd W W
J Bone Joint Surg Am. 1978 Jan;60(1):1-16.
Of 161 patients with 162 shoulders operated on during a thirty-year period (1946 to 1976), 124 were re-examined and twenty-one answered a questionnaire. The lesions found at surgery were separation of the capsule from the anterior glenoid rim in 85 per cent, a Hill-Sachs lesion of the humeral head in 77 per cent, and damage to the anterior glenoid rim (including fracture) in 73 per cent. There were five recurrences (3.5 per cent) after repair by the method described in the 145 shoulders that were followed. Only one of the forty-six patients with dislocation on the dominant side and one of the thirty-one with dislocation on the non-dominant side failed to return to the competitive athletic activities in which they participated prior to injury. The results at follow-up were rated excellent in 74 per cent, good in 23 per cent, and poor in 3 per cent. Ninety-eight per cent of the patients rated their result as excellent or good. Sixty-nine per cent of the shoulders had a full range of motion, and only 2 per cent of these shoulders redislocated. A fracture of the rim of the glenoid did not increase the risk of recurrence, while a moderate to severe Hill-Sachs lesion increased the risk only slightly. We concluded that with the meticulous technique of the Bankart repair as described, postoperative immobilization is not necessary, early return of motion and function can be expected, and resumption of athletic activities with no limitation of shoulder motion is possible for most patients.
在三十年期间(1946年至1976年)对161例患者的162个肩部进行了手术,其中124例接受了复查,21例回答了问卷。手术中发现的损伤情况为:85%的患者关节囊与肩胛盂前缘分离,77%的患者肱骨头有希尔-萨克斯损伤,73%的患者肩胛盂前缘受损(包括骨折)。在随访的145个肩部中,采用所述方法修复后有5例复发(3.5%)。在46例优势侧脱位的患者中,只有1例未能恢复到受伤前参加的竞技体育活动;在31例非优势侧脱位的患者中,也只有1例未能恢复。随访结果评为优秀的占74%,良好的占23%,差的占3%。98%的患者将其结果评为优秀或良好。69%的肩部活动范围正常,其中只有2%的肩部再次脱位。肩胛盂边缘骨折并未增加复发风险,而中度至重度的希尔-萨克斯损伤仅略微增加了复发风险。我们得出结论,采用所述的细致的Bankart修复技术,术后无需固定,有望早期恢复活动和功能,大多数患者可以不受肩部活动限制地恢复体育活动。