【摘要】 目的探讨切开LATARJET手术治疗伴重度肩盂缺损的复发性肩关节前脱位的效果。方法 2016年1月—2019年12月,我科采用切开LATARJET手术治疗伴重度肩盂缺损的复发性肩关节前脱位患者29例,术前及术后末次随访时采用Walch Duplay评分、美国肩肘外科医师协会(ASES)评分、Rowe评分和前屈上举、体侧外旋、外展90°外旋的肩关节活动度对患者功能进行评估,术后使用CT评估喙突移植骨块的位置和愈合情况。结果29例患者术后平均随访26.8个月(16～38个月),术后末次随访时Walch Duplay评分、ASES评分、Rowe评分较术前明显改善(t=11.05～39.27,P<0.05);术后末次随访时患者前屈上举、体侧外旋、外展90°外旋的关节活动度与术前比较,差异有统计学意义(t=2.92～11.90,P<0.05)。结论切开LATARJET手术治疗伴重度肩盂缺损的复发性肩关节前脱位,能重建肩盂解剖结构,恢复肩关节前方稳定,术后功能恢复良好,疗效满意。更多还原

【Abstract】 Objective To investigate the clinical effect of open LATARJET procedure in the treatment of recurrent anterior shoulder dislocation with severe glenoid bone defect. Methods From January 2016 to December 2019, 29 patients with recurrent anterior shoulder dislocation with severe glenoid bone defect were treated by the open LATARJET procedure in our department, and joint functions were evaluated using Walch Duplay score, American Shoulder and Elbow Surgeons(ASES) score, Rowe score, and the range of motion of the shoulder joint including flexion and upward lift, lateral extorsion, and extorsion at 90° extension before surgery and at final follow-up after surgery. CT was used to evaluate the location and healing of the coracoid graft after surgery. Results The 29 patients were followed up for a mean time of 26.8 months(16-38 months), and all patients had significant improvements in Walch Duplay score, ASES score, and Rowe score at final follow-up after surgery(t=11.05-39.27,P<0.05), and there were significant changes in the range of motion of the shoulder joint including flexion and upward lift, lateral extorsion, and extorsion at 90° extension at final follow-up after surgery(t=2.92-11.90,P<0.05). Conclusion In the treatment of recurrent anterior shoulder dislocation with severe glenoid bone defect, open LATARJET procedure can reconstruct the anato-mical structure of the glenoid, restore the anterior stability of the shoulder joint, and help to achieve good functional recovery after surgery, with a satisfactory therapeutic effect.更多还原