开放复位并修复Bankart损伤治疗陈旧性肩关节前脱位(附6例病例分析)

Treatment of Old Anterior Shoulder Dislocation by Open Reduction and Bankart Lesion Repair (Affiliated the Analysis of a Case Series Including 6 Patients)

摘要: 目的：大多数陈旧性肩关节前脱位大多采取切开复位同时不同方式内固定的方法治疗，我们在切开复位的同时对关节囊和关节盂加固修复而放弃贯穿关节间内固定以早期活动减少关节粘连和僵硬，本研究目的就是评估其疗效。方法：6例平均伤后11周的陈旧的肩关节前脱位的病人，给予手术切开复位并行盂唇-关节囊修复加强，术后肩关节外展功能位支架固定，随访8月后进行临床功能和影像学检查按Rowe和Zarin标准评估疗效。结果：全部病人按Rowe和Zarin标准评分，平均83分，3例评为优，2例良，1例一般。所有病例胜任日常活动，伴轻微疼痛或无疼痛，前举平均丧失20˚，外旋丧失20˚，内旋平均丧失2个椎体水平。结论：对陈旧性肩关节前脱位切开复位的同时盂唇-关节囊加固修复的手术方法可取得较好疗效，值得应用推广。

Abstract: Object: Open reduction with different fixation operations has been introduced for most chronic shoulder anterior dislocation. However, open reduction and simultaneous Bankart lesion repair without the joint fixation were used in our study. The aim was to evaluate the outcomes of our method. Methods: Six patients with chronic anterior dislocation of shoulder underwent open re-duction and capsulolabral complex repair after an average delay of 11 weeks after injury. Early motion was allowed the day after surgery in the function position. Then the clinical and radio-graphic results were analyzed at a mean follow-up of 8 months according to Rowe and Zarin’s cri-teria. Results: The average Rowe and Zarin’s score was 83 points. Three out of six shoulders were graded as excellent, two as good and one as fair. All patients were able to complete their daily ac-tivities with either mild or no pain. Anterior active forward flexion loss averaged 20˚, external active rotation loss averaged 20˚ and internal active rotation loss averaged 2 vertebral body levels. Conclusion: The results show that the overall prognosis for this method of operation is more fa-vorable than the previous methods and we recommend open reduction and capsulolabral complex repair for the treatment of old anterior shoulder dislocation.