摘要
背景：肩关节镜下Bankart修复术已得到广泛的认可,但对于复发性Bankart损伤,由于其正常解剖结构受到破坏,经典的前下关节囊盂唇复合体缝合固定很难较好恢复盂肱关节前下方稳定性。目的：探讨关节镜下盂肱中韧带加强固定修复复发性Bankart损伤的方法及疗效。方法：2012年7月至2013年12月,关节镜下修复治疗16例伴有盂唇严重磨损的复发性Bankart损伤患者,男5例,女11例;年龄26~64岁,平均51岁。患者有肩关节不稳症状且反复脱位病史。术中采用关节镜下锚钉缝合残留盂唇同时紧缩加强固定盂肱中韧带于关节盂缘,重建稳定。结果：手术切口均甲级愈合,无感染、再脱位等手术相关并发症发生。16例患者均获随访,随访时间6~21个月,平均14个月。末次随访时,肩关节恐惧试验、前抽屉试验均为阴性,肩关节ASES评分和Rowe评分均优于术前（P〈0.05）。结论：关节镜下盂肱中韧带缝合固定术,可以有效增强肩关节前方的稳定性,是治疗复发性Bankart损伤较好的方法之一。
Background： Arthroscopic Bankart repair has been widely recognized, but for recurrent Bankart injury, because its anatomic structures have been destroyed, it is difficult to recover glenohumeral anterior-inferior stability by suturing capsule labrum complex.Objective： To investigate the methods and efficacy of arthroscopic repair for recurrent Bankart injury by strengthening suture fixation of middle glenohumeral ligment（MGHL）.Methods： From July 2012 to December 2013, 16 patients with recurrent Bankart injuries associated with labral severe wear underwent arthroscopic repair. There were 5 males and 11 females with a mean age of 51 years（range, 26-64 years）. Shoulder instability and a history of recurrent dislocation existed in all patients. Residual labrum was sutured and MGHL was tightly fixed in the glenoid rim to reconstruct shoulder stability.Results： Operative incision healed very well. No surgery- related complications such as infection and dislocation occurred.The mean duration of follow-up was 14 months（range, 6 to 21 months） in the 16 patients. At the last follow-up, the results of the shoulder apprehension test and anterior drawer test were negative, and shoulder ASES score and Rowe score were superior to preoperative one（P〈0.05）.Conclusions： Arthroscopic MGHL strengthening suture fixation can effectively enhance the stability of anterior shoulder. It is one of the good methods for treatment recurrent Bankart injury.
出处
《中国骨与关节外科》
2015年第4期323-326,共4页
Chinese Journal of Bone and Joint Surgery
