关节镜下改良双滑轮技术交叉缝合固定骨性Bankart损伤

Modified double-pulley technology to fix bony Bankart injury with cross suture by arthroscope

目的探讨一种改良双滑轮(double-pulley)交叉缝合技术固定新鲜的骨性Bankart损伤在临床上的使用价值及手术效果。方法回顾2018年1月至2020年10月联勤保障部队第九二〇医院运动医学科20例新鲜骨性Bankart损伤,关节镜下使用一种改良double-pulley技术进行缝合、复位、固定骨折块。采用配对样本t检验比较患侧术前、术后及双侧肩关节活动度、美国肩肘外科评分、Constant-Murley肩关节功能评分、Rowe评分和西安大略肩关节不稳指数。结果20例新鲜骨性Bankart损伤患者术后骨块复位良好,平均随访时间(15.0±2.8)个月。与术前相比,术后患者主观功能评分有显著的提高、疼痛明显好转(t=9.903、2.609、27.107、59.173,均为P<0.05)。术后随访未发现骨折块移位,也无感染、血管神经损伤等其他并发症。结论关节镜下治疗新鲜的骨性Bankart损伤效果良好,使用改良的double-pulley技术在关节镜下交叉缝合固定新鲜的骨性Bankart损伤,复位效果满意。

Objective To explore the clinical value and surgical effect of a modified double-pulley technology to fix fresh bony Bankart with cross suture under arthroscopy.Methods From January 2018,the Department of Sports Medicine of the 920th Hospital of the Joint Logistics Support Force has performed arthroscopic treatment on 20 patients diagnosed with bony Bankart lesion,and used an modified double-pulley technology for suture,reduction,and fixation.The range of motion of shoulder joint,American shoulder and elbow surgery score(ASES),Constant-Murley scores,Rowe scores and the Western Ontario shoulder instability index(WOSI)were compared with paired sample t test.Results From January 2018 to October 2020,20 patients diagnosed with fresh bony Bankart injury were successfully completed.The postoperative X-ray and CT results showed that 20 patients had good bone mass reduction.The average follow-up time of 20 patients was(15.0±2.8)months.Compared with preoperative data,the subjective function scores were significantly improved,and the pain was relieved(t=9.903,2.609,27.107 and 59.173,all P<0.05).No fracture displacement was found in the postoperative follow-up,and no other complication such as infection or vascular nerve injury was found.Conclusions Arthroscopic treatment is effective for fresh bony Bankart injuries.The use of modified double-pulley technology to fix fresh bony Bankart lesion with cross suture under arthroscope can achieve anatomical reduction,and the reduction effect is also satisfactory.