文章摘要
廖炳辉,丁明,甄志雷,上官磊,王迎春,张春礼,徐虎.肩关节镜下锚钉固定位置与跨度对治疗复发性肩关节前脱位预后的影响.骨科,2019,10(4):303-306,313
肩关节镜下锚钉固定位置与跨度对治疗复发性肩关节前脱位预后的影响
Effect of arthroscopic anchor location and span on prognosis of recurrent anterior dislocation
投稿时间:2018-11-14  
DOI:10.3969/j.issn.1674-8573.2019.04.009
中文关键词: 关节镜  复发性肩关节前脱位  锚钉  固定
英文关键词: Arthroscopy  Recurrent anterior dislocation of shoulder joint  Anchor  Fixation
基金项目:
作者单位E-mail
廖炳辉 空军军医大学附属西京医院骨科运动损伤科西安 710032  
丁明 空军军医大学附属西京医院骨科运动损伤科西安 710032  
甄志雷 空军军医大学附属西京医院骨科运动损伤科西安 710032  
上官磊 空军军医大学附属西京医院骨科运动损伤科西安 710032  
王迎春 空军军医大学附属西京医院骨科运动损伤科西安 710032  
张春礼 空军军医大学附属西京医院骨科运动损伤科西安 710032  
徐虎 空军军医大学附属西京医院骨科运动损伤科西安 710032 xuhu2014jiaoxue@163.com 
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中文摘要:
      目的 评估肩关节镜下锚钉内固定术治疗复发性肩关节前脱位的临床疗效,并探讨锚钉固定位置、跨度对临床疗效的影响。方法 2013年1月至2016年6月,前瞻性纳入47例复发性肩关节前脱位病人,关节镜下使用3枚Lupine锚钉固定撕裂的盂唇。术后第2日常规复查肩关节三维CT,以表盘上的时间刻度描述锚钉位点及跨度。采用数字分级法(numerical rating scale, NRS)评估病人的疼痛程度;使用美国肩肘外科医师学会(American Shoulder and Elbow Surgeons, ASES)评分及Constant-Murley评分评估手术前后关节功能。使用丹麦健康与医疗管理局(Danish Health and Medicine Authority)满意度评分表评估病人满意度。分析锚钉固定位置、跨度等因素与Constant-Murley评分的关系。结果 47例病人术后未出现明显并发症,术后的NRS评分、ASES评分、Constant-Murley评分均较术前显著改善,差异均有统计学意义(P均<0.05)。病人满意度评分为(8.2±1.3)分。锚钉跨度越大,Constant-Murley评分越低(F=21.714,P<0.001);锚定位置越高(越接近12点钟位置),Constant-Murley评分越低(F=13.752,P=0.006)。结论 锚钉固定前下盂唇可有效改善病人肩关节功能,有利于肩关节稳定性重建,且锚钉固定的位置及跨度与肩关节术后稳定性相关。
英文摘要:
      Objective To evaluate the clinical efficacy of arthroscopic anchor fixation for recurrent anterior dislocation of shoulder joint, and to explore the influence of anchor location and span on clinical efficacy. Methods From January 2013 to June 2016, 47 patients with recurrent shoulder anterior dislocation were prospectively enrolled in this study. The 3 Lupine anchors were used to fixate tearing glenoid labrum under arthroscopy. After the operation, the three dimensional CT of the shoulder joint was rechecked. The time scale on dial was used to describe anchor location and span. The numerical rating scale (NRS) was used to evaluate the pain. The American Shoulder and Elbow Surgeons (ASES) and Constant-Murley Scores were used to evaluate the function of shoulder joint. The Danish Health and Medical Authority (Danish Health and Medical Authority) satisfaction scale was used to assess patients' satisfaction. The relationship between anchor location, span and Constant-Murley score was analyzed. Results No postoperative complications occurred in all patients. The scores of NRS, ASES and Constant-Murley after operation were significantly improved compared with those before operation, and the differences were statistically significant (P<0.05 for all). The patients' satisfaction score was 8.2±1.3. The longer the anchor span was, the lower the Constant-Murley score was (F=21.714, P<0.001), and the higher the anchor position was (closer to 12 o'clock), the lower the Constant-Murley score was (F=13.752, P=0.006). Conclusion The anterior glenoid labial anchor fixation could effectively improve the shoulder function of the patients, and was conducive to the reconstruction of shoulder stability and satisfactory surgical prognosis. The location and span of anchor fixation are related to the stability of shoulder joint after operation.
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