Torg氏改良的Bristow手术治疗肩关节复发性前脱位

Torg's modified Bristow procedure for recurrent anterior dislocation of the sho ulder joint

目的介绍治疗肩关节复发性前脱位的Torg氏改良的Bristow术式,评价其临床效果。方法采用Torg改良Bristow方法治疗肩关节复发性前脱位31例,平均年龄22.3岁。结果术后随访1～6年(平均44个月),1例手术后2年时发生1次再脱位,3例术后发生过一次或多次的半脱位,8例患者诉肩关节运动时或运动后有轻度疼痛,1例患者因内固定螺钉处疼痛和弹响需去除螺钉。肩关节术后外旋受限10°～15°5例,外展受限10°2例,其余患者肩关节活动范围恢复至术前。其中21例运动员和教练中,有3名运动员虽无再脱位发生,但未能恢复到伤前训练水平,余均达到伤前训练水平。结论Torg改良的Bristow手术方法治疗肩关节多发性前脱位再脱位发生率低,术后肩关节活动受限程度轻,运动员患者恢复伤前训练水平的比例较高,且手术损伤小、步骤简单、易于实施。

Objective To introduce a new modified Bristow procedure for recurrent shoulder dislocation by Joseph S. Torg and to evaluate its clinical re sult. Methods A total of 31 shoulders with recurrent anterior dislocation were t reated with Torgs modified Bristow procedure. The average age was 22.3 years. Results Follow-ups on 31 shoulders (in 31 patients) were obtained at an average postoperative time of 44 months, from 12 months to 6 years. One shoulder experi enced once redislocation and three shoulders had one or more subjective episodes of subluxation after the procedure. The screw needed to be removed in one patie nt for persistent pain. There were eight patients who had mild pain during or af ter sports. Five had loss of external rotation of 10 to 15 degrees and two had l oss of abduction of the shoulder motion of 10 degrees. Of all the 21 patients of professional athletes and coaches, 3 were unable but 18 able to return to their pre-injury level of sport training. Conclusions The redislocation rate of the modified Bristow procedure for the recurrent dislocation of the shoulder by Torg J.S. is low. The loss of the motion range in the glenohumeral joint after the o peration is acceptable, and most professional athletes and coaches can return to their previous sports. In addition, the operation technique is not complicated.