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用于复发性肩关节后脱位的肩胛盂截骨术:通过计算机轴向断层扫描进行评估

Glenoid osteotomy for recurrent posterior subluxation of the shoulder: assessment by computed axial tomography.

作者信息

Hawkins R H

机构信息

University Hospital, University of British Columbia, Canada.

出版信息

J Shoulder Elbow Surg. 1996 Sep-Oct;5(5):393-400. doi: 10.1016/s1058-2746(96)80071-1.

Abstract

Computed axial tomography was used to measure the change in articular alignment of 12 patients who underwent glenoid osteotomy for recurrent posterior subluxation of the shoulder. The average correction was 10.8 degrees and varied from -1 degree to +24 degrees. Local complications were intraarticular fracture because of osteotomy too close to the articular surface, lack of correction caused by loss of the anterior cortical hinge, and graft extrusion causing loss of correction. Osteoarthritis was noted in one case after 8 years. Only 2 of the 12 patients had clinical instability after surgery; however, 3 others continued to feel some shoulder discomfort. Despite uniform surgical technique for osteotomy, graft size, and graft placement, more variability was seen in articular realignment than expected. Given this unpredictability and the known risks of articular damage inherent in osteotomy near a joint surface, glenoid osteotomy for recurrent posterior subluxation should be used with caution.

摘要

采用计算机断层扫描(CT)测量了12例因复发性肩关节后脱位接受关节盂截骨术患者的关节对线变化。平均矫正角度为10.8度,范围为-1度至+24度。局部并发症包括截骨术过于靠近关节面导致的关节内骨折、前皮质铰链丢失导致的矫正不足以及植骨块挤出导致的矫正丢失。8年后有1例出现骨关节炎。12例患者中只有2例术后存在临床不稳定;然而,另外3例仍感到肩部有些不适。尽管在截骨术、植骨块大小和植骨块放置方面采用了统一的手术技术,但关节重新对线的变异性比预期更大。鉴于这种不可预测性以及关节面附近截骨术固有的关节损伤已知风险,对于复发性后脱位行关节盂截骨术应谨慎使用。

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