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[关节镜下经肩胛盂治疗创伤后前肩关节不稳的稳定术]

[Arthroscopic trans-glenoid stabilization of post-traumatic anterior shoulder instability].

作者信息

Steinbeck J, Grenzheuser D H, Jerosch J

机构信息

Klinik und Poliklinik für Allgemeine Orthopädie der Westfälischen Wilhelms-Universität Münster.

出版信息

Z Orthop Ihre Grenzgeb. 1997 May-Jun;135(3):228-32. doi: 10.1055/s-2008-1039585.

Abstract

PURPOSE

Aim of this study was to evaluate the results after athroscopic transglenoidal stabilization in patients with anterior posttraumatic shoulder instability.

METHODS

30 patients with posttraumatic anterior shoulder instability were prospectively observed for a mean of 36 months (24-56) after an athroscopic stabilization has been performed. The operative technique was carried out as described by Morgan with use of transglenoidal sutures to repair the labrum.

RESULTS

All patients had a Bankart lesion and a Hill-Sachs defect. According to the criteria of Rowe, 24 patients (80%) had good or excellent results and 1 patient (3%) was graded as fair. 5 patients (17%) developed recurrent instability 6-24 months postoperatively so they had failed results. 83.4% had no or little limitation in sports activity. Sex, age or grade of activity had no influence on the result concerning stability. The mean preoperative dislocation rate was 8.6 for the failures and 5.9 for the stable results (p < 0.05).

CLINICAL RELEVANCE

The results of arthroscopic stabilization of the shoulder are inferior to the classical open repair. It should only be performed in patients with unidirectional, posttraumatic anterior shoulder instability without capsulaligamentous hyperlaxity or multiple resdislocations.

摘要

目的

本研究旨在评估创伤后肩关节前向不稳患者行关节镜下经盂稳定术后的结果。

方法

对30例创伤后肩关节前向不稳患者在进行关节镜稳定术后进行前瞻性观察,平均观察36个月(24 - 56个月)。手术技术按照摩根所描述的方法进行,使用经盂缝线修复盂唇。

结果

所有患者均有Bankart损伤和Hill - Sachs缺损。根据Rowe标准,24例患者(80%)结果为良好或优秀,1例患者(3%)评定为一般。5例患者(17%)术后6 - 24个月出现复发性不稳,因此结果为失败。83.4%的患者在体育活动中无或仅有轻微受限。性别、年龄或活动程度对稳定性结果无影响。失败组术前平均脱位率为8.6,稳定组为5.9(p < 0.05)。

临床意义

肩关节镜稳定术的结果不如传统的开放修复术。该手术仅应在无关节囊韧带松弛或多次再脱位的单向创伤后肩关节前向不稳患者中进行。

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