镜下肱二头肌长头腱转位修复盂部分缺损

Arthroscopic Bankart repair combined with long head of the biceps transfer for partial bony glenoid defect

[目的]探讨关节镜下Bankart修复联合肱二头肌长头腱转位治疗合并部分肩胛盂骨缺损的复发性肩关节前向不稳定的疗效。[方法] 2016年9月—2018年1月,本科收治14例伴有部分肩胛盂骨缺损的复发性肩关节前脱位患者,其中男10例,女4例,年龄24~47岁,平均(30.22±3.77)岁,患者有肩关节不稳症状和反复脱位病史,采用关节镜下Bankart修复联合肱二头肌腱转位进行治疗。[结果]手术切口均愈合良好,12例患者获得随访,随访时间12~28个月,平均(21.38±3.49)个月,末次随访时,肩关节恐惧试验、前抽屉试验均为阴性,肩关节无再脱位,肩关节ASES评分和Rowe评分均优于术前(P<0.05)。[结论]关节镜下Bankart修复联合肱二头肌腱转位术,可以有效增强肩关节前方的稳定性,是治疗伴有部分肩胛盂骨缺损的复发性肩关节脱位的有效方法。

[Objective] To investigate the efficacy of arthroscopic Bankart repair combined with the biceps long head tendon transfer for recurrent anterior shoulder instability accompanied with partial bony glenoid defect. [Methods] From September 2016 to January2018, 14 patients received arthroscopic repair of Bankart lesion combined with the biceps long head tendon transfer for recurrent anterior shoulder instability accompanied with partial bony glenoid defect. All the patients, including10 males and 4 females aged 24~47 years, presented shoulder instability with history of recurrent dislocation. [Results] All the patients got surgical incision healed well, and 12 patients of them were followed for 12 to 28 months with an average of(21.38±3.49) months. At the latest follow-up, all patient had negative apprehension test and anterior drawer test, without re-dislocation, whereas with the significantly improved ASES score and Rowe score compared with those preoperatively(P<0.05). [Conclusion] The arthroscopic repair of Bankart lesion combined with biceps long head tendon transfer does effectively enhance the glenohumeral stability, is an effective treatment method for recurrent anterior shoulder instability accompanied with partial bony glenoid defects.