Terry G C, Friedman S J, Uhl T L
Hughston Clinic, PC, Columbus, GA 31995.
Am J Sports Med. 1994 Jul-Aug;22(4):504-12. doi: 10.1177/036354659402200412.
Labral tears and associated glenohumeral ligament injuries were classified and treated arthroscopically in 83 patients. Transverse labral tears were the most common. Subtle increased glenohumeral translation was noted in 24% of patients. Glenohumeral ligament injury was present in 58% of the shoulders, with the middle and superior ligaments or middle ligaments alone most commonly involved. These ligament injuries were classified into different groups based on severity. Partial excision of the torn labrum was the primary treatment in all patients and was combined with glenohumeral ligament repair in 9 patients. Seventy-eight patients were available for subjective follow-up evaluation (average, 3.2 years), while 53 patients were objectively evaluated (average followup, 2.8 years). There were 14% excellent, 71% satisfactory, and 15% poor results. The main factor associated with poor results was a grade III glenohumeral ligament injury in which only partial excision of the torn labrum was performed. There was a positive correlation between injury to both the superior and middle glenohumeral ligaments and increased anterior translation demonstrated by preoperative stability testing at 60 degrees of humeral abduction in neutral rotation. We believe glenohumeral ligament injury is often associated with labral tears and arthroscopic partial labral excision is only effective in those patients who have grade I or II (less severe) glenohumeral ligament injuries.
对83例患者的盂唇撕裂及相关的盂肱韧带损伤进行了关节镜下分类和治疗。横行盂唇撕裂最为常见。24%的患者存在盂肱关节平移轻度增加。58%的肩部存在盂肱韧带损伤，最常累及的是中、上韧带或单独的中韧带。这些韧带损伤根据严重程度分为不同组。所有患者均以撕裂盂唇部分切除术作为主要治疗方法，9例患者同时进行了盂肱韧带修复。78例患者接受了主观随访评估（平均3.2年），53例患者接受了客观评估（平均随访2.8年）。结果为优的占14%，良的占71%，差的占15%。与差的结果相关的主要因素是III级盂肱韧带损伤，其中仅对撕裂的盂唇进行了部分切除。在肱骨外展60度中立旋转时，术前稳定性测试显示，上、中盂肱韧带损伤与前向平移增加呈正相关。我们认为，盂肱韧带损伤常与盂唇撕裂相关，关节镜下部分盂唇切除术仅对I级或II级（较轻）盂肱韧带损伤的患者有效。
