CAJ | 학술논문

目的探讨在瞄准器配合下通过骨隧道撬顶复位+填塞植骨矫正Hill-Sachs损伤的可行性.方法将30具肩关节标本分为三组,每组10具标本,按照肱骨头凹陷性骨缺损的10%(A组)、20%(B组)和30%(C组)复制Hill-Sachs损伤.先埘各组骨缺损进行测量,再住瞄准器配合下,通过骨隧道对B组和C组进行撬顶复位,填塞植骨;然后采用配对t检验对B组和C组骨缺损在复位前后的横向弧长度、纵向弧长度、深度和体积进行分析比较.结果复位前B组和C组骨缺损的横向弧长度为(10.9 ±1.4)mm和(16.3 ±2.3)mm;纵向弧长度为(22.4±2.4)mm和(28.0 ±2.2)mm;深度为(6.9±0.9)mm和(11.1 ±0.9)mm;体积为(708.7 ±93.9)mm3和(1 338.3 ±185.6)mm3.复位后B组和C组骨缺损的横向弧长度为(5.1 ±2.4)mm 和(7.6±3.6)mm;纵向弧长度为(10.5±4.9)mm和(12.3±5.3)mm;深度为(0.3 ±0.1)mm和(0.4±0.1)mm;体积为(48.9 ±16.1)mm3和(70.3±37.9)mm3.两组所有参数进行手术前后的配对比较显示,差异有统计学意义(P<0.01).结论在瞄准器配合下,通过骨隧道撬顶复位,填塞植骨能够有效修复肱骨头凹陷性骨缺损为20%～30%的Hill-Sachs损伤.
목적 탐토재묘준기배합하통과골수도효정복위+전새식골교정Hill-Sachs손상적가행성.방법장30구견관절표본분위삼조,매조10구표본,안조굉골두요함성골결손적10%(A조)、20%(B조)화30%(C조)복제Hill-Sachs손상.선시각조골결손진행측량,재주묘준기배합하,통과골수도대B조화C조진행효정복위,전새식골;연후채용배대t검험대B조화C조골결손재복위전후적횡향호장도、종향호장도、심도화체적진행분석비교.결과복위전B조화C조골결손적횡향호장도위(10.9 ±1.4)mm화(16.3 ±2.3)mm;종향호장도위(22.4±2.4)mm화(28.0 ±2.2)mm;심도위(6.9±0.9)mm화(11.1 ±0.9)mm;체적위(708.7 ±93.9)mm3화(1 338.3 ±185.6)mm3.복위후B조화C조골결손적횡향호장도위(5.1 ±2.4)mm 화(7.6±3.6)mm;종향호장도위(10.5±4.9)mm화(12.3±5.3)mm;심도위(0.3 ±0.1)mm화(0.4±0.1)mm;체적위(48.9 ±16.1)mm3화(70.3±37.9)mm3.량조소유삼수진행수술전후적배대비교현시,차이유통계학의의(P<0.01).결론 재묘준기배합하,통과골수도효정복위,전새식골능구유효수복굉골두요함성골결손위20%～30%적Hill-Sachs손상.
Objective To determine whether the poking reduction and bone grafting technique with guide through bony tunnel can correct a Hill-Sachs lesion. Methods A total of 30 cadaveric humeri were equally divided into three groups, 10 cadaveric humeri per group. Hill-Sachs lesions were replicated with a osseous defect involving 10% (group A ) , 20% (group B ) and 30% (group C ) of the articular surface. All the bone defects in each group were measured and the poking reduction and bone grafting technique with guide through a bony tunnel was performed in group B and group C. The preoperative and postoperative transverse arc length, longitudinal are length, depth and volume of the osseous defects in group B and group C were compared by using paired t test. Results Before reduction, the transverse arc length of the bone defects was ( 10.9 ± 1.4 )mm in group B and ( 16.3 ± 2.3 ) mm in group C ; longitudinal arc length was ( 22.4 ± 2.4 ) mm in group B and ( 28.0 ± 2.2 ) mm in group C ;depth was (6.9±0.9) mm in group B and (11. 1 ±0.9) mm in group C; volume was (708.7±93.9) mm3 in group B and (1338.3 ± 185.6) mm3 in group C. After reduction, the transverse arc length of the bone defects was (5.1 ± 2.4 ) mm in group B and ( 7.6 ± 3.6 ) mm in group C ; longitudinal arc lengthwas (10.5 ±4.9) mm in group B and (12.3 ±5.3) mm in group C; depth was (0.3±0.1 ) mm in group B and (0.4 ±0.1 ) mm in group C; volume was (48.9 ± 16.1 )mm3 in group B and (70.3 ± 37.9) mm3 in group C. The comparison of all the parameters showed statistical difference (P <0. 01 ). Conclusion The poking reduction and bone grafting technique with guide through a bony tunnel can effectively correct the Hill-Sachs lesions with humeral head osseous defects involving 20% -30% of the articular surface.