关节镜下盂唇缝合治疗肩关节前方不稳

Arthroscopic labrum suture in treatment of anterior shoulder instability

目的介绍关节镜下盂唇缝合治疗肩关节前方脱位的技术,并评价其临床疗效。方法回顾性研究2010年2月—2012年2月收治的肩关节前脱位患者21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,采用关节镜下检查,盂唇anchor钉缝合固定治疗。疗效评估用加州大学洛杉矶分校(UCLA)功能评分。结果术后21例患者均获得随访,最长24个月,最短3个月,平均11个月。术前UCLA评分平均为(19.5±7.1)分,终末期随访时UCLA评分平均为(32.8±6.6)分,与术前评分比较,差异有显著性(t=3.35,P<0.05)。患者均能正常工作和生活,恢复原有工作、运动。结论关节镜下盂唇缝合治疗肩关节前下脱位手术效果良好,具有诊断与治疗一体化优点。手术的成功有赖于术前严格把握适应症,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。

Objective To introduce arthroscopic dishes lip suture treatment ahead shoulder joint dislocation of the tech- nology, and evaluate its clinical efficacy. Methods By retrospective study in February 2010 to February 2012, before the shoulder joint dislocation of 21 cases of patients, including malel5 cases and female 6 cases ; Age ： 25 - 45 years old. All patients have clear trauma history, preoperative screening ahead there is not stable, imaging examination were not combined fracture, the arthroscopic examination, dishes lip anchor nail suture fixed treatment. Curative effect evaluation with the university of California, Los Angeles （UCLA） function score. Results Totally 21 cases of postoperative pa- tients were followed up for, the longest 24 months, the shortest 3 months, mean a November. Preoperative UCLA score average （ 19. 5 and 7.1 ） points, end - stage follow - up UCLA when scoring average （32. 8 and 6. 6） points, and pre- operative score comparison, with significant difference （ t = 3.35, P 〈 0. 05 ）. Patients who can work as normal person, restore original work, sports. Conclusion Arthroseopic dishes lip suture treatment of shoulder joint dislocation before operation effect is good, which has the advantages of integration of diagnosis and treatment. The success of the operation depends on preoperative strictly grasp the indications, intraoperative arthroscopic operation technical proficiency and ear- ly postoperative rehabilitation training in time.