关节镜手术与保守治疗青年人群初次肩关节前脱位的临床疗效(1)
摘 要：目的 比较关节镜手术与保守方法治疗青年人群初次肩关节前脱位的临床疗效。方法 回顾性分析2010年1月～2013年7月我院64例诊断为急性初次肩关节前肩脱位的患者资料。其中32例患者行关节镜修复术为关节镜手术组，32例患者行保守治疗为保守治疗组，随访5年。比较两组WOSI指数评分，肩膀、手和手臂的残疾评分。结果 保守治疗组23例患者在5～18个月后发生再次脱位；关节镜手术组仅有2例患者在术后1年出现再次脱位。随访18个月后，关节镜手术组患者WOSI评分、DASH评分均高于保守治疗组，差异有统计学意义(P<0.05)；末次随访显示，两组患者(包括复发性脱位进行关节镜稳定术患者)WOSI评分、DASH评分比较，差异无统计学意义(P>0.05)。结论 关节镜手术治疗青年人群初次肩关节前脱位的复发率较低，患者肩关节稳定性较好，肩膀及手功能恢复较好。
关键词：青年人群；肩关节；关节镜；初次前脱位
中图分类号：R684.7 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.020
, 百拇医药
文章编号：1006-1959(2018)22-0073-04
Clinical Efficacy of Arthroscopic Surgery and Conservative Treatment of Initial Anterior Shoulder Dislocation in Young People
GAO Yan-wen1，2，XU Cong2，LV Yong-ming2
(1.Graduate School of Chengde Medical College，Chengde 067000，Hebei，China；
2.Department of Joint Surgery，Affiliated Hospital of Chengde Medical College，Chengde 067000，Hebei，China)
, 百拇医药
Abstract：Objective To compare the clinical efficacy of arthroscopic surgery and conservative methods in the treatment of initial anterior shoulder dislocation of the young people.Methods A retrospective analysis of 64 patients with a diagnosis of initial anterior shoulder dislocation of the shoulder from January 2010 to July 2013 was performed. Among them， 32 patients underwent arthroscopic surgery for arthroscopic surgery， and 32 patients underwent conservative treatment for conservative treatment. The follow-up period was 5 years. The two groups of WOSI index scores， shoulder， hand and arm disability scores were compared.Results 23 patients in the conservative treatment group were dislocated again after 5 to 18 months. Only 2 patients in the arthroscopic surgery group had dislocation again at 1 year after surgery. After 18 months of follow-up， the WOSI score and DASH score of the arthroscopic surgery group were higher than those of the conservative treatment group， the difference was statistically significant (P<0.05). The last follow-up showed that the two groups of patients (including recurrent dislocation for arthroscopy).There were no significant differences in WOSI scores and DASH scores between the patients (P>0.05). Conclusion Arthroscopic surgery has a lower recurrence rate of initial anterior shoulder dislocation in young people. The shoulder joint stability is better and shoulder and hand function recovery is better.
Key words：Young people；Shoulder joint；Arthroscopy；Initial anterior dislocation
肩關节前脱位(scapular dislocation)是年轻人中常见的损伤，占所有主要关节脱位的50%[1，2]。肩关节脱位的常见并发症包括复发性不稳和半脱位，特别是在接受保守治疗的年轻患者中。治疗原发性肩关节前肩脱位是复杂和具有挑战性的，患者的特定变量包括年龄、职业、功能要求、体育参与、身体特征和依从性使决定用哪种治疗方法进一步复杂化。无论是保守治疗还是手术治疗，目标是肩关节稳定、无痛，能够完全恢复受伤前的运动范围。本研究旨在研究青年人群初次肩关节前脱位的关节镜手术与保守方法治疗的临床疗效。, 百拇医药(高砚文 徐丛 吕永明)
关键词：青年人群；肩关节；关节镜；初次前脱位
中图分类号：R684.7 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.020
, 百拇医药
文章编号：1006-1959(2018)22-0073-04
Clinical Efficacy of Arthroscopic Surgery and Conservative Treatment of Initial Anterior Shoulder Dislocation in Young People
GAO Yan-wen1，2，XU Cong2，LV Yong-ming2
(1.Graduate School of Chengde Medical College，Chengde 067000，Hebei，China；
2.Department of Joint Surgery，Affiliated Hospital of Chengde Medical College，Chengde 067000，Hebei，China)
, 百拇医药
Abstract：Objective To compare the clinical efficacy of arthroscopic surgery and conservative methods in the treatment of initial anterior shoulder dislocation of the young people.Methods A retrospective analysis of 64 patients with a diagnosis of initial anterior shoulder dislocation of the shoulder from January 2010 to July 2013 was performed. Among them， 32 patients underwent arthroscopic surgery for arthroscopic surgery， and 32 patients underwent conservative treatment for conservative treatment. The follow-up period was 5 years. The two groups of WOSI index scores， shoulder， hand and arm disability scores were compared.Results 23 patients in the conservative treatment group were dislocated again after 5 to 18 months. Only 2 patients in the arthroscopic surgery group had dislocation again at 1 year after surgery. After 18 months of follow-up， the WOSI score and DASH score of the arthroscopic surgery group were higher than those of the conservative treatment group， the difference was statistically significant (P<0.05). The last follow-up showed that the two groups of patients (including recurrent dislocation for arthroscopy).There were no significant differences in WOSI scores and DASH scores between the patients (P>0.05). Conclusion Arthroscopic surgery has a lower recurrence rate of initial anterior shoulder dislocation in young people. The shoulder joint stability is better and shoulder and hand function recovery is better.
Key words：Young people；Shoulder joint；Arthroscopy；Initial anterior dislocation
肩關节前脱位(scapular dislocation)是年轻人中常见的损伤，占所有主要关节脱位的50%[1，2]。肩关节脱位的常见并发症包括复发性不稳和半脱位，特别是在接受保守治疗的年轻患者中。治疗原发性肩关节前肩脱位是复杂和具有挑战性的，患者的特定变量包括年龄、职业、功能要求、体育参与、身体特征和依从性使决定用哪种治疗方法进一步复杂化。无论是保守治疗还是手术治疗，目标是肩关节稳定、无痛，能够完全恢复受伤前的运动范围。本研究旨在研究青年人群初次肩关节前脱位的关节镜手术与保守方法治疗的临床疗效。, 百拇医药(高砚文 徐丛 吕永明)