Speck M, Hertel R
Klinik für Orthopädische Chirurgie der Universität Bern, Inselspital.
Z Orthop Ihre Grenzgeb. 1997 Jul-Aug;135(4):348-53. doi: 10.1055/s-2008-1039400.
From May 1992 to September 1995, 38 patients with recurrent anterior shoulder instability underwent arthroscopic stabilization. The arthroscopic stabilization was performed by capsular shifting and labral refixation using Mitek anchors, based on the Wolf procedure. Immediately after operation active assisted shoulder mobilization was initiated (elevation 60 degrees, external rotation 20 degrees less than contralateral shoulder). After a mean follow-up of 24 months (12-42 months) 30 patients were evaluated by means of the Rowe Score. Excellent and good results were achieved in 90% (n = 27) of patients and 80% had no restriction in sports activities. In 4 of the patients (13%) redislocation occurred. Analysis of the recurrence revealed no adequate trauma in two patients with preoperative multidirectional laxity. One had a trauma and the fourth showed no compliance in the early postoperative period. Compared to the open Bankart operation the described procedure shows a slightly higher rate of redislocations. However, the approach is less invasive and the subscapularis tendon with its proprioception remains intact.
1992年5月至1995年9月,38例复发性前肩不稳患者接受了关节镜下稳定手术。关节镜下稳定手术基于Wolf手术,采用Mitek锚钉进行关节囊移位和盂唇重新固定。术后立即开始主动辅助肩部活动(抬高60度,外旋比健侧少20度)。平均随访24个月(12 - 42个月)后,采用Rowe评分对30例患者进行评估。90%(n = 27)的患者获得了优良结果,80%的患者在体育活动方面没有限制。4例患者(13%)发生了再脱位。复发分析显示,术前存在多向性松弛的2例患者没有足够的创伤。1例有创伤,第4例在术后早期不配合。与开放性Bankart手术相比,所述手术的再脱位率略高。然而,该方法侵入性较小,肩胛下肌腱及其本体感觉保持完整。