肩关节镜下Bankart术治疗复发性肩关节前脱位

Arthroscopic Bankart procedure for recurrent anterior dislocation of the shoulder

目的探讨肩关节镜下Bankart术治疗复发性肩关节前脱位的适应症、手术要点和疗效。方法对我科2007年1月至2009年7月,15例复发性肩关节前脱位的临床资料进行回顾性分析。15例均为肩关节单方向不稳定,左侧4例,右侧11例,术前脱位次数为2-30次,平均为11.7次。所有患者均采用锚钉进行关节镜下Bankart术,术后采用Constant-Murley法进行评分。结果术后随访10-24个月,平均12.5个月,所有患者均未出现切口感染及关节腔积血等并发症。终末随访时平均Constant-Murley评分较术前明显改善(术前79.3±4.0对术后95.0±2.2,P<0.01)。终末随访时所有病例均未发生再脱位,术后无残存恐惧试验阳性。结论关节镜下Bankart术是治疗复发性肩关节前脱位的有效方法之一。

Objective To explore the indications,surgical key points and therapeutic effects of arthroscopic Bankart procedure for treatment of recurrent anterior dislocation of the shoulder. Methods From January 2007 to July 2009,15 patients with recurrent anterior dislocation of shoulder were analyzed retrospectively. All patients were diagnosed as unidirectional shoulder instability, including 4 cases of left shoulder dislocation and 11 cases of right shoulder dislocation . The preoperative average dislocation times were 11.7 times （range from 2 to 30 times）. All patients underwent arthroscopic Bankart procedure using metal anchors nail. Constant-Murley score were used to evaluate shoulder function. Results All patients were followed up for an average of 12.5 months （range from 10 to 24 months）,without wound infection and iutra-articular hemorrhage.Significant improvement was detected by Constant-Murley score （preop.79.3±4.0 vs postop.95.0±2.2,P〈0.01）.There were no dislocation after operation and no positive results of apprehension test. Conclusion Arthroscopic Bankart procedure is one of an effective approaches for treatment of recurrent anterior dislocation of the shoulder.