天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (12): 1507-1509.doi: 10.11958/20161222

• 临床研究 • 上一篇    下一篇

Neer 改良 Mclaughlin 手术治疗肩关节后脱位合并反Hill-sachs 损伤的疗效分析

杨涛1 ， 陈啸2 ， 张蔚然3 ， 李超英4 ， 魏万富5△   

  1. 1天津市天津医院骨科 （邮编300211）， 2运动损伤与关节镜科； 3天津市公安医院骨科； 4天津市第四中心医院骨科； 5天津市天津医院创伤骨科
  • 收稿日期:2016-10-25 修回日期:2016-11-09 出版日期:2016-12-15 发布日期:2017-01-26
  • 通讯作者: 魏万富 △通讯作者 E-mail: weiwanfu01@sina.com E-mail:89528086@qq.com
  • 作者简介:杨涛 （1986）， 男， 住院医师， 硕士， 主要从事骨、 软骨损伤方向的研究

Clinical effects of shoulder dislocation combined with reverse Hill-sachs injury treated with Neer modified McLaughlin procedure

YANG Tao1 , CHEN Xiao2 , ZHANG Weiran3 , LI Chaoying4 , WEI Wanfu5△   

  1. 1 Department of Orthopaedic Surgery, 2 Department of Sports Medicine and Arthroscopy, Tianjin Hospital, Tianjin 300211, China; 3 Department of Orthopaedic Srugery, Tianjin Public Security Hospital; 4 Department of Orthopaedic Surgery, Tianjin Fourth Central Hospital; 5 Trauma Department of Orthopedic Surgery, Tianjin Hospital
  • Received:2016-10-25 Revised:2016-11-09 Published:2016-12-15 Online:2017-01-26
  • Contact: WEI Wanfu △Corresponding Author E-mail: weiwanfu01@sina.com E-mail:89528086@qq.com

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摘要： 摘要： 目的 探讨 Neer 改良 Mclaughlin 手术治疗肩关节后脱位合并反 Hill-sachs 损伤的临床疗效。方法 回顾性分析 2013 年 10 月—2016 年 6 月天津市天津医院收治 7 例肩关节后脱位合并反 Hill-sachs 损伤患者的临床资料， 患者肱骨头缺损面积为 25%～40%， 全部采用 Neer 改良 Mclaughlin 手术予以治疗。根据末次随访时患者影像学表现、 主观满意度、 肩关节活动度、 Constant 评分、 UCLA 评分进行临床疗效评估。结果 患者术后平均随访 （12.3± 4.3） 个月， 末次随访时均未出现肩关节脱位复发。影像学检查发现 1 例患者出现轻微骨关节炎。主观满意度评价方面 2 例患者表示对手术效果非常满意， 其余 5 例患者表示满意； 关节活动范围前屈 145.7°±12.7°， 外展 148.6°±15.7°，外旋 47.1°±5.7°； Constant 评分 （78.6±7.2） 分， 肩关节 UCLA 评分 （26.6±2.8） 分。结论 Neer 改良 Mclaughlin 手术治疗肩关节后脱位合并反 Hill-sachs 损伤的临床效果显著， 术后中短期随访患者功能恢复良好， 并发症少。

关键词: 肩脱位, 改良 Mclaughlin 手术, 肩关节后脱位, 反 Hill-sachs 损伤, 治疗效果

Abstract: Abstract: Objective To evaluate clinical efficacy of shoulder dislocation combined with reverse Hill-sachs injury treated with Neer modified McLaughlin procedure. Methods Clinical data of seven patients for shoulder dislocation combined with reverse Hill-sachs injury in our hospital from October 2013 to June 2016 were retrospectively analyzed. All of the patients were received Neer modified McLaughlin procedure with defect area of humeral head from 25% to 40%. The clinical outcomes were evaluated with plain radiographs, subjective satisfaction, range of shoulder motion, University of Califonia Los Angeles (UCLA) shoulder scale and constant score, which were recorded at the final follow up. Results The mean follow-up period was (12.3±4.3) months. No recurence of shoulder dislocation was found. At the final follow up, a patient was found a slight osteoarthritis based on radiographs. Two patients were very satisfied with the surgery and five patients were satisfied. The average anterior flexion, abduction and external rotation of shoulder were 145.7° ± 12.7° and 148.6°±15.7° and 47.1°±5.7° respectively. The average UCLA score and constant score were (26.6±2.8) and (78.6±7.2) respectively. Conclusion The Neer modified McLaughlin procedure shows a remarkable clinical effect for shoulder dislocation combined with reverse Hill-sachs injury. The short and mid-term effects are definite with few complications.

Key words:  shoulder dislocation, modified Mclaughlin procedure, posterior shoulder dislocation, reverse Hill-sachs lesion, treatment outcome