Surgical Treatment of Recurrent Anterior Dislocation of the Should with Cruciate Capsular Reconstruction

關節囊轉移及交叉縫合重建術治療復發性肩關節前方脫臼

吳濬哲(Jiunn-Jer Wu) ； 許弘昌(H. C. Hsu) ； 張政彥(C. Y. Chang) ； 羅惠熙(W. H. Lo)

《Journal of Orthopaedic Surgery Taiwan》 10卷2期 (1993/06) Pp. 205-212

摘要

本文係研究六十五例復發性肩關節前方脫臼處，以關節囊轉移及交叉縫合重建術，經術後五十四個月之追蹤檢查。雙重對比肩關節電腦斷層攝影，對於此族群並灶之診斷精確率高達92.3%；邦卡氏病灶96.2%及肱骨頭缺損50.8%，是復發性肩關節前方脫臼之兩個主要病變。
至目前為止，並無病例在脫臼，也無神經肌肉損傷之併發症。依據羅威功能評估表，此族群62例回復到優至極優之狀況；三分之二的病患可復原到受傷前的運動功能，如投、擲、推、拉等動作。
手術治療關節不穩定，最主要是使肩關節穩定度復原；同時保有肩關節完整的活動功能。根據本文之臨床經驗及追蹤結果，效果極佳；此手術方法值得極力推薦。

並列摘要

Sixty five cases were studied with a follow-up period of 54 months after the capsular shifting procedure for recurrent anterior should dislocation. The diagnostic accuracy of pathological lesion with double contrast CT arthrogram was 92.3% (60/65). Ban-kart’s lesion 86.2%(58/65) and Hill-Sacks lesion 50.8% (33/65) were the two main findings.
For the time being there was neither recurrence nor neuromuscular complication. Rowe’s rating score was applied for the functional assessment, 62 of 65 cases (95.4%) were rating in good to excellent conition. Two-third of cases could return to preinjury full sports activities: throwing, over-head, push-ups without any limitation.
The main goals on surgery for the shoulder instability are to establish good stability and preserve the full range of motion. Based on our clinical experience and results, this procedure is highly recommended.

並列關鍵字

Recurrent anterior dislocation of the shoulder ； Capsular shift with cruciate repair