肩关节不稳盂唇复合体6点钟位锚钉置入手术技巧
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陆军第七十三集团军医院

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urgical skill of 6 o''clock anchor insertion in labrum complex of shoulder instability
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Department of Orthopedics, Chenggong Hospital, Xiamen University, Xiamen 361003, China

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    摘要:

    [目的]介绍关节镜下6点钟位锚钉置入盂唇缝合治疗肩关节前方不稳的手术技巧,并评价其临床疗效。[方法]2018年01月01日-2021年1月1日收治的肩关节前方不稳患者51 例,所有患者有明确外伤史,术前查体存在前方不稳定,影像学检查均未合并骨折,采用关节镜下盂唇缝合治疗肩关节不稳。[结果]术后51患者均获得随访,平均随访时间 18.8 个月(12~24个月)。所有患者术后肩关节前屈上举、内旋与术前无明显统计学差异,术后外展90o外旋较健侧平均受限8.5o±4.9o,末次随访所有患者均未再出现术后再次脱位,ASES 评分由术前的(81.04±3.49)分增加至末次随访时的(92.23±2.62)分,差异具有统计学意义(P<0.01)Constant-Murley 评分由术前的(90.04±2.90)分增加至末次随访时的(95.71±1.68)分,差异具有统计学意义(P<0.01) ;Rowe 评分由术前的(64.47±6.20)分增加至末次随访时的(92.38±2.33)分,差异具有统计学意义(P<0.01)。[结论]关节镜下6点钟位锚钉置入盂唇缝合治疗肩关节不稳手术效果良好。手术的成功有赖于术前严格把握适应证,术中关节镜下操作技术的熟练程度以及术后早期及时的康复锻炼。

    Abstract:

    [Objective] To introduce the surgical technique of 6 o ''clock anchor insertion in labrum for the treatment of anterior shoulder instability under arthroscopy, and to evaluate its clinical efficacy.[Methods] Fifty-one patients who has anterior shoulder instability were admitted from January 1, 2018 to January 1, 2021. All patients who had a definite history of injury was treated by Arthroscopic labrum repair, after their preoperative physical examination showed anterior instability and imaging examination showed no fracture. [Results] All 51 patients were followed up for an average of 18.8 months (12-24 months). There were no statistically significant differences between active forward elevation,and internal rotation after the surgery, postoperative abduction 90o external rotation was 8.5o±4.9o more limited than the normal side, and no postoperative re-dislocation occurred in all patients in the last follow-up. The American Shoulder and Elbow Society (ASES) score increased from (81.04±3.49) before surgery to (92.23±2.62) at the last follow-up,additionally ,the constant-Murley score increased from (90.04±2.90) before surgery to (95.71±1.68) at the last follow-up,moreover,Rowe score by preoperative (64.47 ±6.20) points up to at the time of the last follow-up (92.38±2.33) as well, and all the differences was statistically significant (P<0.01). [Conclusion] Arthroscopy at 6 o ''clock position anchor insertion labrum suture for the treatment of shoulder instability is effective. The success of the operation depends on the strict grasp of preoperative indications, the proficiency of intraoperative arthroscopy and early postoperative rehabilitation exercise.

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  • 收稿日期:2022-05-15
  • 最后修改日期:2022-05-15
  • 录用日期:2022-09-02
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