目的探讨关节镜下Bankart修复术治疗复发性肩关节前脱位的中期疗效。方法回顾性分析2017年1月—2021年6月符合选择标准的107例复发性肩关节前脱位患者临床资料,均接受关节镜下Bankart修复术。男88例,女19例;患者初次脱位年龄13~48岁,平...目的探讨关节镜下Bankart修复术治疗复发性肩关节前脱位的中期疗效。方法回顾性分析2017年1月—2021年6月符合选择标准的107例复发性肩关节前脱位患者临床资料,均接受关节镜下Bankart修复术。男88例,女19例;患者初次脱位年龄13~48岁,平均23.3岁;脱位次数2~160次,中位次数7次;病程0.2~240.0个月,中位病程36.0个月。手术时年龄16~61岁,平均28.2岁。左肩43例,右肩64例。63例合并关节盂骨缺损,骨缺损达1.7%~16.1%,平均8.1%。MRI检查示均不合并肩袖撕裂和肩关节僵硬。术后1 d行CT三维重建检查,评估植入锚钉分布以及锚钉植入处有无关节盂劈裂骨折和拔钉等情况发生。观察术后并发症发生情况,采用疼痛视觉模拟评分(VAS)、Rowe评分、Constant-Murley评分、美国肩肘外科医师协会(ASES)评分评估患肩疼痛及功能。记录术后患者肩关节不稳复发情况、恐惧试验结果、恢复至术前运动水平患者例数以及患者自评满意度。结果手术均顺利完成。患者均获随访,随访时间20~73个月,平均41.5个月。术后切口均Ⅰ期愈合。术后1 d CT三维重建检查示,锚钉均位于2∶00~5∶30区域且在关节盂表面边缘,无拔钉及锚钉植入处劈裂骨折发生。末次随访时,VAS评分低于术前,Rowe评分、Constant-Murley评分及ASES评分均较术前增高,差异有统计学意义(P<0.05)。7例(6.5%)于术后23~55个月肩关节前脱位复发,平均39.9个月;其中脱位6例、半脱位1例。末次随访时,51例患者(47.7%)恢复至术前运动水平,11例(10.3%)恐惧试验阳性。患者自评满意率为90.7%(97/107);10例手术效果不满意者中,7例术后肩关节不稳复发,3例自觉未恢复至术前运动水平。结论对于关节盂骨缺损少、运动需求不高的复发性肩关节前脱位患者,关节镜下Bankart修复术治疗可获得良好的中期疗效。展开更多
Purpose: The aim of this study was to present our surgical outcomes in patients who underwent arthroscopic removal of poorly positioned and/or proud metallic suture anchors applied during or after Bankart repair. Meth...Purpose: The aim of this study was to present our surgical outcomes in patients who underwent arthroscopic removal of poorly positioned and/or proud metallic suture anchors applied during or after Bankart repair. Methods: A total of 14 patients who underwent open or arthroscopic Bankart repair with an initial presentation of traumatic shoulder instability between January 2010 and January 2017 and admitted to our center with complaints due to poorly positioned and/or proud metallic suture anchors were enrolled. Pre- and intraoperative findings, surgical outcomes and complications were reviewed. Diagnosis of proud or poorly positioned suture anchors was established using magnetic resonance imaging (MRI) of shoulder in five cases, and with shoulder arthroscopy in nine patients. Outcomes were measured by the use of the CONSTANT score and American Shoulder and Elbow Society (ASES) score. Results: Eleven male and three female patients with an average age of 29.21 ± 5.78 (range, 20 to 42) were enrolled in the present study. Revision Bankart repair was performed arthroscopically in all patients. The mean follow-up period was 40.4 months, ranging from 18 to 64 months. The preoperative Constant and ASES scores were 68.43 ± 7.05 and 38.3 ± 19.4, respectively. Postoperatively, the scores were 89.64 ± 5.39 and 89.07 ± 3.89, respectively (p Conclusion: To conclude, arthroscopy may yield an effective surgical option for removal of poorly positioned and/or proud metallic suture anchors after Bankart repair. However, further clinical reports on larger series are warranted to document the efficacy of this procedure in selected cases.展开更多
目的观察电针联合手牵足蹬手法复位对初次肩关节脱位患者肩关节功能的影响。方法将78例初次肩关节脱位的患者,随机分为对照组和观察组,每组39例。对照组采用手牵足蹬法复位进行治疗,观察组在对照组的基础上联合电针治疗。观察两组治疗前...目的观察电针联合手牵足蹬手法复位对初次肩关节脱位患者肩关节功能的影响。方法将78例初次肩关节脱位的患者,随机分为对照组和观察组,每组39例。对照组采用手牵足蹬法复位进行治疗,观察组在对照组的基础上联合电针治疗。观察两组治疗前后Neer肩关节功能评分、Rowe氏评分系统中稳定性及活动度评分、肩关节角度及治疗前、出院时和出院后1个月疼痛视觉模拟量表(visual analog scale,VAS)评分变化,并比较两组不良反应发生率。结果治疗后,两组Neer肩关节功能评分各项评分及总分均升高(P<0.05),且观察组疼痛和运动范围评分及总分高于对照组(P<0.05);两组Rowe氏评分中的稳定性和活动度评分均升高(P<0.05),且观察组高于对照组(P<0.05);两组前屈上举、外展外旋角度均增大(P<0.05),且观察组大于对照组(P<0.05),两组体侧外旋角度比较差异无统计学意义(P>0.05)。两组出院时、出院后1个月VAS评分均低于治疗前,且观察组出院时、出院后1个月VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论针刺联合手牵足蹬手法复位可改善初次肩关节脱位患者的肩关节功能及疼痛情况,无明显不良反应,是一种安全、有效的治疗方法。展开更多
文摘目的探讨关节镜下Bankart修复术治疗复发性肩关节前脱位的中期疗效。方法回顾性分析2017年1月—2021年6月符合选择标准的107例复发性肩关节前脱位患者临床资料,均接受关节镜下Bankart修复术。男88例,女19例;患者初次脱位年龄13~48岁,平均23.3岁;脱位次数2~160次,中位次数7次;病程0.2~240.0个月,中位病程36.0个月。手术时年龄16~61岁,平均28.2岁。左肩43例,右肩64例。63例合并关节盂骨缺损,骨缺损达1.7%~16.1%,平均8.1%。MRI检查示均不合并肩袖撕裂和肩关节僵硬。术后1 d行CT三维重建检查,评估植入锚钉分布以及锚钉植入处有无关节盂劈裂骨折和拔钉等情况发生。观察术后并发症发生情况,采用疼痛视觉模拟评分(VAS)、Rowe评分、Constant-Murley评分、美国肩肘外科医师协会(ASES)评分评估患肩疼痛及功能。记录术后患者肩关节不稳复发情况、恐惧试验结果、恢复至术前运动水平患者例数以及患者自评满意度。结果手术均顺利完成。患者均获随访,随访时间20~73个月,平均41.5个月。术后切口均Ⅰ期愈合。术后1 d CT三维重建检查示,锚钉均位于2∶00~5∶30区域且在关节盂表面边缘,无拔钉及锚钉植入处劈裂骨折发生。末次随访时,VAS评分低于术前,Rowe评分、Constant-Murley评分及ASES评分均较术前增高,差异有统计学意义(P<0.05)。7例(6.5%)于术后23~55个月肩关节前脱位复发,平均39.9个月;其中脱位6例、半脱位1例。末次随访时,51例患者(47.7%)恢复至术前运动水平,11例(10.3%)恐惧试验阳性。患者自评满意率为90.7%(97/107);10例手术效果不满意者中,7例术后肩关节不稳复发,3例自觉未恢复至术前运动水平。结论对于关节盂骨缺损少、运动需求不高的复发性肩关节前脱位患者,关节镜下Bankart修复术治疗可获得良好的中期疗效。
文摘Purpose: The aim of this study was to present our surgical outcomes in patients who underwent arthroscopic removal of poorly positioned and/or proud metallic suture anchors applied during or after Bankart repair. Methods: A total of 14 patients who underwent open or arthroscopic Bankart repair with an initial presentation of traumatic shoulder instability between January 2010 and January 2017 and admitted to our center with complaints due to poorly positioned and/or proud metallic suture anchors were enrolled. Pre- and intraoperative findings, surgical outcomes and complications were reviewed. Diagnosis of proud or poorly positioned suture anchors was established using magnetic resonance imaging (MRI) of shoulder in five cases, and with shoulder arthroscopy in nine patients. Outcomes were measured by the use of the CONSTANT score and American Shoulder and Elbow Society (ASES) score. Results: Eleven male and three female patients with an average age of 29.21 ± 5.78 (range, 20 to 42) were enrolled in the present study. Revision Bankart repair was performed arthroscopically in all patients. The mean follow-up period was 40.4 months, ranging from 18 to 64 months. The preoperative Constant and ASES scores were 68.43 ± 7.05 and 38.3 ± 19.4, respectively. Postoperatively, the scores were 89.64 ± 5.39 and 89.07 ± 3.89, respectively (p Conclusion: To conclude, arthroscopy may yield an effective surgical option for removal of poorly positioned and/or proud metallic suture anchors after Bankart repair. However, further clinical reports on larger series are warranted to document the efficacy of this procedure in selected cases.
文摘目的观察电针联合手牵足蹬手法复位对初次肩关节脱位患者肩关节功能的影响。方法将78例初次肩关节脱位的患者,随机分为对照组和观察组,每组39例。对照组采用手牵足蹬法复位进行治疗,观察组在对照组的基础上联合电针治疗。观察两组治疗前后Neer肩关节功能评分、Rowe氏评分系统中稳定性及活动度评分、肩关节角度及治疗前、出院时和出院后1个月疼痛视觉模拟量表(visual analog scale,VAS)评分变化,并比较两组不良反应发生率。结果治疗后,两组Neer肩关节功能评分各项评分及总分均升高(P<0.05),且观察组疼痛和运动范围评分及总分高于对照组(P<0.05);两组Rowe氏评分中的稳定性和活动度评分均升高(P<0.05),且观察组高于对照组(P<0.05);两组前屈上举、外展外旋角度均增大(P<0.05),且观察组大于对照组(P<0.05),两组体侧外旋角度比较差异无统计学意义(P>0.05)。两组出院时、出院后1个月VAS评分均低于治疗前,且观察组出院时、出院后1个月VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论针刺联合手牵足蹬手法复位可改善初次肩关节脱位患者的肩关节功能及疼痛情况,无明显不良反应,是一种安全、有效的治疗方法。
