采用微创前路手术治疗肩关节前路软组织不稳定后的功能结果

M. Tosic, Nikola Vukosav, Milan Majkić, Branko Baljak, Milan Milinkov, S. Ninkovic
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介绍。本文的目的是介绍和分析采用微创前路开放手术技术治疗肩关节前路软组织不稳的结果,并强调在高危患者中使用开放手术的好处。材料和方法。所有患者于2013年1月至2017年9月期间在诺维萨德骨科外科和创伤科诊所接受了手术。138例因前肩不稳而接受手术的患者中,有40例进行了随访检查。受试者的平均年龄为27岁?6. 对每位患者进行病史检查,并检查手术肩关节活动度和肌肉力量。受试者填写了一份调查问卷,内容涉及手术后肩部的功能状况、恢复体育活动的经历以及主观疼痛感。采用Constant-Murley评分评估术后结果。结果。术后平均Constant-Murley评分为90.3 ?11.5%,优良率87.5%。与对侧未损伤肩关节相比,外展肩关节外旋的Constant-Murley评分(13.2?? 10.4?),肩关节内收(10.25?? 9.7 ?)。在35名运动员患者中,27名患者在手术治疗后继续积极从事体育运动。4例患者发生再脱位(10%)。结论。采用微创前路开放手术治疗肩关节前失稳是一种可靠的、经过时间考验的手术方法,在及时诊断和手术护理的情况下,对年轻的高风险接触和头顶运动员提供了良好的临床结果。
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Functional outcomes after surgical treatment of anterior soft-tissue shoulder instability using a minimally invasive anterior approach
Introduction. The purpose of this paper is to present and analyze the results of treatment of anterior soft-tissue shoulder instability using an open surgical technique with a minimally invasive anterior approach, as well as to emphasize the benefits of using an open surgical procedure in high-risk patients. Material and Methods. All patients underwent surgery at the Clinic of Orthopedic Surgery and Traumatology in Novi Sad in the period between January 2013 and September 2017. Out of 138 patients undergoing surgery for anterior shoulder instability, 40 patients came for follow-up examination. The average age of subjects was 27 ? 6. Medical history was taken from each patient and the range of motion and muscle strength of the operated shoulder was examined. The subjects filled out a questionnaire regarding the functional status of the operated shoulder, their experience in resuming sports activities, and their subjective feeling of pain. The Constant-Murley score was used to assess the postoperative results. Results. Postoperatively, the mean Constant-Murley score was 90.3 ? 11.5, while 87.5% patients had excellent and good results. Compared to the contralateral uninjured shoulder, there was a statistically significant difference (p < 0.05) in the Constant-Murley score, in external rotation of the abducted shoulder (13.2? ? 10.4?), as well as in shoulder adduction (10.25? ? 9.7?). Out of 35 patients who were athletes, 27 continued to actively engage in sports following the surgical treatment. Four patients had a re-dislocation (10%). Conclusion. Open surgical treatment of the anterior shoulder joint instability using a minimally invasive anterior approach is a reliable, time-tested procedure that provides favorable clinical results in young high-risk contact and overhead athletes with timely diagnosis and surgical care.
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