Mizuno K, Nabeshima Y, Hirohata K
Department of Orthopaedic Surgery, Kobe University School of Medicine, Japan.
Clin Orthop Relat Res. 1993 Mar(288):158-65.
The Bankart repair was used to restore anterior stability to 50 patients (51 shoulders) with recurrent dislocation or subluxation of the shoulder. The patients had preoperative diagnostic testing to determine the presence and extent of a Bankart lesion. At surgery, the Bankart lesion was carefully observed for its location, and extent of involvement of associated structures. The intraoperative findings of the severity of the Bankart lesion were compared with the preoperative data. The glenoidal fossa was considered like a clock, and the location and severity of the Bankart lesion was expressed by the hour of the clock. The Bankart lesion most frequently occurred from two o'clock to six o'clock in the right shoulder, and from six o'clock to ten o'clock in the left shoulder. The region of the glenohumeral joint at highest risk of exhibiting pathology after recurrent dislocation or subluxation of the shoulder was usually located from the central anterior edge of the glenohumeral joint to the inferior margin. Arthrogram with computed tomography was the most useful preoperative diagnostic test to demonstrate the Bankart lesion. The greatest number of inferior postoperative results were observed in patients with Bankart lesions of large size.
采用Bankart修复术对50例(51个肩关节)复发性肩关节脱位或半脱位患者进行前方稳定性重建。患者术前行诊断性检查以确定Bankart损伤的存在及范围。手术时,仔细观察Bankart损伤的位置及相关结构的累及范围。将术中Bankart损伤严重程度的结果与术前数据进行比较。将肩胛盂窝视为一个时钟,Bankart损伤的位置和严重程度用时钟的小时数表示。Bankart损伤最常发生于右肩的两点至六点以及左肩的六点至十点。复发性肩关节脱位或半脱位后最易出现病变的盂肱关节区域通常位于盂肱关节中央前缘至下缘。关节造影联合计算机断层扫描是术前显示Bankart损伤最有用的诊断检查。Bankart损伤面积大的患者术后效果最差。