关节镜Bankart修复术与改良Bankart修复术治疗创伤性复发性肩关节前脱位近期疗效比较

Comparison of Short-term Curative Effect of Arthroscopic Bankart Repair and Modified Bankart Repair in Treatment of Traumatic Recurrent Anterior Shoulder Dislocation

目的观察关节镜Bankart修复术与改良Bankart修复术治疗创伤性复发性肩关节前脱位近期疗效。方法选取2014年2月—2017年2月收治的创伤性复发性肩关节前脱位90例,按治疗方式分为研究组与对照组,每组45例。对照组应用改良Bankart修复术,研究组应用关节镜Bankart修复术。采用Bigliani肩关节不稳手术修复后稳定性评分系统、Rowe修正评分系统和疼痛视觉模拟评分(VAS)标准对患者进行肩关节功能评估。结果研究组术后Bigliani肩关节不稳手术修复后稳定性评分中疼痛、活动范围、活动水平评分及总分高于对照组(P<0.05)。研究组Rowe肩关节修正评分中稳定性、活动度、功能评分及总分高于对照组(P<0.05)。术后,2组VAS评分低于术前,且研究组低于对照组(P<0.05)。随访期间手术切口愈合良好,肩关节正常活动完全恢复。对照组1例在早期负重时出现轻微肩关节前方疼痛,经加强功能训练及对症治疗后疼痛症状逐渐消失。结论关节镜下行Bankart修复术治疗创伤性复发性肩关节前脱位临床疗效优于开放性Bankart修复术,且术后疼痛程度明显降低,更能快速恢复肩关节的正常解剖结构,最大程度地恢复其正常生物力学功能。

Objective To observe the short-tell1 curative effect of arthroscopic Bankart repair and modified Bankart repair in treatment of traumatic recurrent anterior shoulder dislocation. Methods A total of 90 patients with traumatic recurrent anterior shoulder dislocation admitted during February 2014 and February 2017 were divided into study group and control group （ n = 45 for each group） according to different treatment methods. Control group was treated with modified Bankart repair, while study group was treated with arthroscopic Bankart repair. Shoulder joint functions were e- valuated using Bigliani shoulder joint instability of postoperative restoration stability scoring system, Rowe correction scoring system and visual analogue scale （VAS）. Results Scores of pain, activities range and activities, and the total score by Bigliani shoulder joint instability of postoperative restoration stability scoring system in study group were significantly higher than those in control group （P 〈 0.05 ）. Stability, activity and functional scores, and the total score by Rowe correction scoring system in study group were significantly higher than those in control group （ P 〈 0.05 ）. After surgery, VAS scores were significantly lower than those before surgery in two groups, and the score in study group was significantly lower than that in control group （ P 〈 0.05 ）. During follow-up, all incisions reached primary healing, and normal activities of shoulder joints recovered well. A patient in control group had slight anterior shoulder pain in early weight-bearing, and pain symptoms gradually disappear after strengthening functional training and symptomatic treatment. Conclusion Arthroscopic Bankart repair in treatment of traumatic recurrent anterior shoulder dislocation may achieve better clinical effect, obviously decrease postoperative pain, quickly recover normal anatomical structure the shoulder and maximize restoration of normal biomechanical function compared with those by modified Bankart repair.