关节镜下双排锚钉治疗肩关节前侧盂缘骨折的临床疗效观察

Clinical effect of arthroscopic treatment for anterior glenoid rim fractures using double-row anchors

目的观察关节镜下双排锚钉修复肩关节前侧盂缘骨折的中长期临床疗效。方法自2011年5月至2014年2月,观察我院收治的19例肩关节盂前侧骨折患者,年龄在21~52岁,平均年龄34.9岁。所有患者采用双排锚钉缝合技术对移位的关节盂骨折进行复位,固定,采用视觉模拟评分法(Visual Analogue Scale,VAS)评分、Constant肩关节评分,ROWE肩关节功能评分,记录关节肩关节活动度,对比术前、术后随访数据评估其临床效果。结果平均随访时间为3.5年。VAS评分从术前7.3±1.4下降到1.4±0.7,明显缓解(t=6.332,<0.01),Constant评分由术前42.1±4.9,到术后89.8±5.4,有明显改善(t=5.827,P<0.01);ROWE评分由术前66.1±11.6,改善为91.7±3.6(t=8.305,P<0.01);关节活动度均有改善。结论关节镜下采用双排锚钉治疗关节盂前侧骨折,损伤小,解剖复位,固定牢靠,中长期效果满意。

Objective To investigate the medium-long term outcomes of arthroscopic treatment of anterior glenoid rim fractures using double-row anchors. Methods From May 2011 to Feb 2014, Nineteen patients with anterior glenoid rim fractures underwent arthroscopic double-row repair were retrospectively analyzed. The mean age of the patients was 34.9 years（range, 21 to 52 years）. The shoulder joint range of motion（ROM）, the visual analog pain scale scores（VAS scores）, Constant scores, ROWE scores were used for clinical and functional evaluations before and post treatment.Results The mean duration of follow-up was 3.5 years, before treatment compared with final follow-up for VAS scores（7.3±1.4 points vs 1.4±0.7 points, t=6.332, P〈0.05）, Constant scores（42.1±4.9 points vs 89.8±5.4 points, t=5.827,P〈0.01）, and ROWE scores（66.1±11.6 points vs 91.7±3.6 points, t=8.305, P〈0.01）, overall, functional outcome was improved. Conclusion Arthroscopic double-row repair had small damage, an anatomic reduction and fixation of the glenoid fracture, and good medium-long term result for treatment of anterior glenoid rim fractures.