CAJ | 학술논문

目的评价肱骨关节面复位加大块植骨治疗陈旧性交锁肩关节后脱位的疗效及结果.方法 2002年3月-2008年4月,对18例陈旧性交锁肩关节后脱位的患者,采用肱骨关节面复位加大块植骨进行手术治疗.全部患者受伤至接受手术时间平均为5个月,术前CT检查证实为陈旧性交锁肩关节后脱位,其中8例肱骨头前缘缺损(反Hill～Sachs征)在20%～25%之间,10例在25%～45%之间.结果术后随访1～4年,平均2.6年.肩关节功能采用Constant评分:优7例,良9例,中1例,差1例;优良率为88.8%.1例患者术后肩关节僵直,但未有复发脱位.UCLA评分最高35分,最低13分,平均30分.结论采用肱骨关节面复位加大块植骨治疗创伤导致陈旧性交锁肩关节后脱位,疗效肯定,肩关节功能恢复良好.
목적 평개굉골관절면복위가대괴식골치료진구성교쇄견관절후탈위적료효급결과.방법 2002년3월-2008년4월,대18례진구성교쇄견관절후탈위적환자,채용굉골관절면복위가대괴식골진행수술치료.전부환자수상지접수수술시간평균위5개월,술전CT검사증실위진구성교쇄견관절후탈위,기중8례굉골두전연결손(반Hill～Sachs정)재20%～25%지간,10례재25%～45%지간.결과 술후수방1～4년,평균2.6년.견관절공능채용Constant평분:우7례,량9례,중1례,차1례;우량솔위88.8%.1례환자술후견관절강직,단미유복발탈위.UCLA평분최고35분,최저13분,평균30분.결론 채용굉골관절면복위가대괴식골치료창상도치진구성교쇄견관절후탈위,료효긍정,견관절공능회복량호.
Objective To evaluate the results of management of chronic locked posterior dislocation of the shoulder by surgical reduction with bone graft to restore joint surface of the humeral head. Methods From March 2002 to April 2008, 18 patients were treated for chronic locked posterior dislocation of the shoulder. They all were treated surgically to reduce the shoulder and restore humeral head joint surface with large bone graft. Mean time between trauma and surgery was 5 months. Preoperative CT scan confirmed shoulder posterior dislocation and a reverae Hill-Sachs lesion in all 18 patients, 8 of them with bone loss from 20% to 25% and 10 within 25% to 45%. scored for the Constant score (CS) and UCLA score at follow up. Results Postoperatively the patients were followed up for 1 to 4 years, with an average of 2.6 years. Shoulder function was evaluated using the Constant score and UCLA score. According Constant scoring 7 cases were rated as excellent, 9 cases as good, 1 case as fair and 1 case as poor. The average rate of excellent and good results was 88.8%. Only 1 case had stiff shoulder, but no recurrent dislocation occurred. UCLA score was 35 for the highest and 13 for the lowest, the mean being 30. Conclusion Open reduction and bone grafting resulted in good midterm results for the patients with traumatic chronic locked posterior dislocation of the shoulder.