全镜下改良“仙后座”技术与“平行桥”技术在治疗肩关节骨性Bankart损伤中应用

The application of modified “Cassiopeia” technique and “parallel bridge” technique in the treatment of bony Bankart injury of shoulder joint

目的探讨全镜下应用改良“仙后座”技术与“平行桥”技术治疗肩关节骨性Bankart损伤的临床疗效。方法选取自2017年4月至2019年1月收治的肩关节骨性Bankart损伤并行肩关节镜手术治疗的16例患者为研究对象。患者术中均采用关节镜下改良“仙后座”技术与“平行桥”技术,应用带线锚钉缝合撕脱骨块及关节囊于缺损部位。记录并比较术前、术后美国肩肘协会评分系统(ASES)评分、Rowes评分,以及术后并发症发生情况。结果本组16例患者均获得3~6个月随访,平均随访(4.0±2.2)个月。末次随访时,患者均能进行正常工作及训练任务,无肩关节再次脱位现象。患者肩关节外旋活动度丢失(12.0°±3.8°)。术后,患者ASES评分为(91.7±8.6)分,显著高于术前的(49.6±17.6)分;患者Rowe评分为(90.1±12.9)分,显著高于术前的(25.2±10.1)分,差异均有统计学意义(P<0.05)。患者均未出现关节内或浅表感染、深静脉血栓等并发症。结论关节镜下应用改良“仙后座”技术与“平行桥”技术修复骨性Bankart损伤所致的肩关节前下脱位,可有效恢复肩关节前方稳定性,促进损伤部位愈合,有助于改善肩关节功能。

Objective To investigate the clinical effect of modified“Cassiopeia”technique and“parallel bridge”technique in the treatment of bone Bankart injury of shoulder joint.Methods A retrospective study was performed on 16 cases of patients with bone Bankart injury of shoulder joint and underwent shoulder arthroscopy were admitted from April 2017 to January 2019.The modified“Cassiopeia”technique and“parallel bridge”technique under arthroscopy were used to suture avulsion of bone and joint capsule at the defect site with thread anchor.The American association of shoulders and elbows scoring system(ASES)score,Rowes score and postoperative complications were recorded and compared.Results All the 16 patients in this group were followed up for 3 to 6 months,with an average follow-up of(4.0±2.2)months.At the last follow-up,all the patients were able to perform normal work and training tasks,and no shoulder joint dislocation occurred again.The patient had a loss of external rotation range of motion(12.0°±3.8°).After surgery,patients′ASES score was(91.7±8.6),significantly higher than that before surgery(49.6±17.6).The Rowe score of the patients was(90.1±12.9),significantly higher than that before surgery(25.2±10.1),and the difference was statistically significant(P<0.05).None of the patients had intra-articular or superficial infection,deep venous thrombosis or other complications.Conclusion The application of modified“Cassiopesia”technique and“parallel bridge”technique under arthroscopy to repair the anterior and inferior dislocation of shoulder joint caused by bone Bankart injury can effectively restore the anterior stability of shoulder joint,promote the healing of the injured site,and help improve the function of shoulder joint.