Neer改良Mclaughlin手术治疗肩关节后脱位合并反Hill-sachs损伤的疗效分析

Clinical effects of shoulder dislocation combined with reverse Hill-sachs injury treated with Neer modified McLaughlin procedure

目的探讨Neer改良Mclaughlin手术治疗肩关节后脱位合并反Hill-sachs损伤的临床疗效。方法回顾性分析2013年10月—2016年6月天津市天津医院收治7例肩关节后脱位合并反Hill-sachs损伤患者的临床资料，患者肱骨头缺损面积为25%～40%，全部采用Neer改良Mclaughlin手术予以治疗。根据末次随访时患者影像学表现、主观满意度、肩关节活动度、Constant评分、UCLA评分进行临床疗效评估。结果患者术后平均随访（12.3±4.3）个月，末次随访时均未出现肩关节脱位复发。影像学检查发现1例患者出现轻微骨关节炎。主观满意度评价方面2例患者表示对手术效果非常满意，其余5例患者表示满意；关节活动范围前屈145.7°±12.7°，外展148.6°±15.7°，外旋47.1°±5.7°；Constant评分（78.6±7.2）分，肩关节UCLA评分（26.6±2.8）分。结论Neer改良Mclaughlin手术治疗肩关节后脱位合并反Hill-sachs损伤的临床效果显著，术后中短期随访患者功能恢复良好，并发症少。

Objective To evaluate clinical efficacy of shoulder dislocation combined with reverse Hill-sachs injury treated with Neer modified McLaughlin procedure. Methods Clinical data of seven patients for shoulder dislocation combined with reverse Hill-sachs injury in our hospital from October 2013 to June 2016 were retrospectively analyzed. All of the patients were received Neer modified McLaughlin procedure with defect area of humeral head from 25% to 40%. The clinical outcomes were evaluated with plain radiographs, subjective satisfaction, range of shoulder motion, University ofCalifonia Los Angeles (UCLA) shoulder scale and constant score, which were recorded at the final follow up. Results Themean follow-up period was (12.3±4.3) months. No recurence of shoulder dislocation was found. At the final follow up, apatient was found a slight osteoarthritis based on radiographs. Two patients were very satisfied with the surgery and fivepatients were satisfied. The average anterior flexion, abduction and external rotation of shoulder were 145.7°±12.7° and148.6°±15.7° and 47.1°±5.7° respectively. The average UCLA score and constant score were (26.6±2.8) and (78.6±7.2)respectively. Conclusion The Neer modified McLaughlin procedure shows a remarkable clinical effect for shoulder dislocation combined with reverse Hill-sachs injury. The short and mid-term effects are definite with few complications.