Kiss J, Mersich I, Perlaky G Y, Szollas L
Department of Orthopaedics, Semmelweis University of Medicine, Budapest, Hungary.
J Shoulder Elbow Surg. 1998 Sep-Oct;7(5):495-500. doi: 10.1016/s1058-2746(98)90201-4.
The results of 90 primary Putti-Platt operations were studied with an average follow-up of 9 years. Seventy of the patients underwent a clinical examination, a functional assessment, and radiologic examination and completed a questionnaire. Twenty patients completed only the questionnaire. The redislocation rate was 9%. Eleven percent of the patients had pain at rest, and 35% had pain on activity. Ninety percent of the patients had restriction of external rotation both at the side of the body (average loss 24 degrees) and in 90 degrees abduction (average loss 23 degrees). Twenty (29%) of the shoulders showed moderate and 1 (1%) shoulder severe osteoarthritis. Only 3 (4%) of the nonoperated shoulders showed moderate arthritis, and none had severe arthritis. Eighty-three percent of patients were fully satisfied, 13% were partly satisfied, and 4% were not satisfied with the result of the operation. The authors conclude that the incidence and severity of osteoarthritis, the incidence of pain, and the limitation of external rotation are significantly increased after the Putti-Platt operation.
对90例初次Putti-Platt手术的结果进行了研究,平均随访9年。70例患者接受了临床检查、功能评估和影像学检查,并完成了一份问卷。20例患者仅完成了问卷。再脱位率为9%。11%的患者静息时疼痛,35%的患者活动时疼痛。90%的患者身体一侧的外旋受限(平均丧失24度),在90度外展位时外旋也受限(平均丧失23度)。20例(29%)肩部显示中度骨关节炎,1例(1%)肩部显示重度骨关节炎。未手术的肩部中只有3例(4%)显示中度关节炎,无重度关节炎。83%的患者对手术结果完全满意,13%的患者部分满意,4%的患者对手术结果不满意。作者得出结论,Putti-Platt手术后骨关节炎的发生率和严重程度、疼痛发生率以及外旋受限均显著增加。