Lusardi D A, Wirth M A, Wurtz D, Rockwood C A
Department of Orthopedic Surgery, United States Air Force Medical Center, Lackland Air Force Base, San Antonio, Texas 78236-5300.
J Bone Joint Surg Am. 1993 Aug;75(8):1185-92. doi: 10.2106/00004623-199308000-00008.
A retrospective study was performed on twenty shoulders in nineteen patients who had been managed for severe loss of external rotation of the glenohumeral joint after a previous anterior capsulorrhaphy for recurrent instability. All patients had noted a restricted range of motion, and seventeen shoulders had been painful. In seven shoulders, the humeral head had been subluxated or dislocated posteriorly, and sixteen shoulders had been affected by mild to severe glenohumeral osteoarthrosis. All twenty shoulders were treated with a reoperation, which consisted of a release of the anterior soft tissue. In addition, eight shoulders had a total arthroplasty and one had a hemiarthroplasty. At an average duration of follow-up of forty-eight months, all shoulders had an improvement in the ratings for pain and range of motion. The average increase in external rotation was 45 degrees (range, 25 to 65 degrees). Patients who have a major loss of external rotation following anterior capsulorrhaphy of the shoulder may be at risk for the development of posterior subluxation and glenohumeral osteoarthrosis. The performance of an anterior release should be considered for these patients.
对19例患者的20个肩部进行了一项回顾性研究，这些患者在先前因复发性不稳定而行肩关节前关节囊缝合术后出现严重的肩关节外旋丧失。所有患者均注意到活动范围受限，17个肩部疼痛。7个肩部肱骨头向后半脱位或脱位，16个肩部受到轻度至重度的肩关节骨关节炎影响。所有20个肩部均接受了再次手术，包括松解前部软组织。此外，8个肩部进行了全关节置换术，1个肩部进行了半关节置换术。平均随访48个月时，所有肩部的疼痛和活动范围评分均有改善。外旋平均增加45度（范围为25至65度）。肩部前关节囊缝合术后出现严重外旋丧失的患者可能有发生后脱位和肩关节骨关节炎的风险。对于这些患者，应考虑进行前部松解术。
