自体髂骨移植弹性固定术治疗复发性肩关节脱位伴关节盂骨缺损早期疗效研究

Analysis of the early effect of elastic fixation with autogenous iliac bone graft on recurrent shoulder dislocation with glenoid bone defect

目的讨关节镜下自体髂骨移植弹性固定术对青年复发性肩关节脱位伴关节盂骨缺损的早期疗效。方法回顾性分析自2020年1月至2022年6月期间收治的21例复发性肩关节脱位伴关节盂骨缺损患者的临床资料,均采用关节镜下自体髂骨移植弹性固定术治疗。以疼痛视觉模拟评分(VAS)、美国加州大学肩关节系统评分(UCLA)、美国肩肘外科协会评分(ASES)及Rowe评分表评估肩关节功能。术后复查肩关节CT+三维重建评估骨块位置、肩盂缺损纠正程度及骨块愈合吸收情况。结果21例患者均得到完整随访,随访时间(8.5±2.4)个月,所有患者手术顺利,均未发生严重术后并发症或再次脱位。患者术后2周VAS评分及半年随访时UCLA评分、ASES评分及Rowe评分均较术前明显改善,差异有统计学意义(P<0.05)。术后半年影像学检查提示所有患者移植骨块位置满意并已愈合,肩关节盂有效面积达正常水平。结论在青年复发性肩关节脱位伴关节盂骨缺损的治疗中,自体髂骨移植弹性固定术具有手术时间短、创伤小等优点,术后肩关节功能恢复可靠且无复发,疗效满意。

Objective To investigate the early effect of elastic fixation with autogenous iliac bone graft under arthroscope on young patients with recurrent shoulder dislocation and glenoid bone defect.Methods The clinical data of 21 patients with recurrent dislocation of shoulder joint with glenoid defect admitted from January 2020 to June 2022 were retrospectively analyzed.Postoperative visual analogue scale(VAS),university of California at Los Angeles shoulder rating scale(UCLA),American shoulder and elbow surgeons(ASES),Rowe scoring system was adopted for curative effect evaluation.Results All 21 cases have been followed up for an average of(8.5±2.4)months.All patients underwent successful surgery without serious postoperative complications or re-dislocation.The VAS score of the patient was significantly improved at 2 weeks after surgery,and the UCLA score,ASES score and Rowe score were significantly improved at 6 months follow-up.Imaging examination six months after operation indicated that the bone graft was satisfactory and healed in all patients,and the effective area of shoulder glenoid reached normal level.Conclusion Elastic fixation iliac bone transplantation has the advantages of short operation time,less trauma,reliable recovery of shoulder joint function without recurrence,and satisfactory effect.