自体髂骨移植联合骨隧道修复固定肩胛下肌止点治疗三例陈旧性肩关节后脱位合并反 Hill-Sachs 损伤_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 罗德军 ¹ , 黄富国 ² , 戢勇 ¹ , 杨博 ¹ , 何发友 ¹ , 牟遐平 ¹ , 朱庆茂 ¹ , 张兆尧 ¹

1. ;
2. ;

Corresponding author：

罗德军, Email: 1027815520@qq.com

Keywords：

陈旧性损伤; 肩关节后脱位; 反 Hill-Sachs 损伤; 自体髂骨; 骨隧道

DOI：

10.7507/1002-1892.202101050

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目的总结自体髂骨移植联合骨隧道修复固定肩胛下肌止点治疗 3 例陈旧性肩关节后脱位合并反 Hill-Sachs 损伤的经验。方法 2017 年 2 月—2020 年 3 月，收治 3 例（5 侧）陈旧性肩关节后脱位合并反 Hill-Sachs 损伤男性患者。患者年龄分别为 45、50、49 岁；单侧 1 例，双侧 2 例。其中，4 侧采用自体髂骨移植修复肱骨头、埋头空心加压螺钉固定联合骨隧道修复固定肩胛下肌止点，1 侧采用半肩关节置换。结果术后切口均Ⅰ期愈合，无臂丛及血管损伤等并发症发生。3 例患者分别获随访 36、15、10 个月。末次随访时，疼痛视觉模拟评分（VAS）及美国加州大学洛杉矶分校（UCLA）评分均优于术前。除关节置换侧肩关节外展及前屈活动明显受限外，其余 4 侧肩关节功能均恢复较好，但 X 线片示存在创伤性肩关节炎。结论陈旧性肩关节后脱位合并反 Hill-Sachs 损伤选择自体髂骨移植联合骨隧道修复固定肩胛下肌止点可获得较好疗效。

Citation： 罗德军, 黄富国, 戢勇, 杨博, 何发友, 牟遐平, 朱庆茂, 张兆尧. 自体髂骨移植联合骨隧道修复固定肩胛下肌止点治疗三例陈旧性肩关节后脱位合并反 Hill-Sachs 损伤. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(6): 789-791. doi: 10.7507/1002-1892.202101050 Copy

1.	Nacca C, Gil JA, Badida R, et al. Critical glenoid bone loss in posterior shoulder instability. Am J Sports Med, 2018, 46(5): 1058-1063.
2.	Hawkes DH, Khaiyat OA, Howard AJ, et al. Patterns of muscle coordination during dynamic glenohumeral joint elevation: an EMG study. PLoS One, 2019, 14 (2): e0211800. doi: 10.1371/journal.pone.0211800.
3.	吴晓明, 蔡明, 东靖明, 等. 肩关节后脱位诊断与治疗的专家共识. 中国骨与关节杂志, 2019, 8(8): 610-616.
4.	Seo JB, Yoon SH, Yang JH, et al. Irreducible posterior fracture and dislocation of shoulder with massive rotator cuff tear due to incarceration of biceps tendon: a case report. J Orthop, 2020, 21: 6-9.
5.	Haroun HK, Sobhy MH, Abdelrahman AA. Arthroscopic Bankart repair with remplissage versus Latarjet procedure for management of engaging Hill-Sachs lesions with subcritical glenoid bone loss in traumatic anterior shoulder instability: a systematic review and meta-analysis. J Shoulder Elbow Surg, 2020, 29(10): 2163-2174.
6.	Konda SR, Fisher N, Gage M, et al. Posterior fracture dislocation of the shoulder: A modified McLaughlin procedure. J Orthop Trauma, 2017, 31 Suppl 3: S36-S37.

1. Nacca C, Gil JA, Badida R, et al. Critical glenoid bone loss in posterior shoulder instability. Am J Sports Med, 2018, 46(5): 1058-1063.
2. Hawkes DH, Khaiyat OA, Howard AJ, et al. Patterns of muscle coordination during dynamic glenohumeral joint elevation: an EMG study. PLoS One, 2019, 14 (2): e0211800. doi: 10.1371/journal.pone.0211800.
3. 吴晓明, 蔡明, 东靖明, 等. 肩关节后脱位诊断与治疗的专家共识. 中国骨与关节杂志, 2019, 8(8): 610-616.
4. Seo JB, Yoon SH, Yang JH, et al. Irreducible posterior fracture and dislocation of shoulder with massive rotator cuff tear due to incarceration of biceps tendon: a case report. J Orthop, 2020, 21: 6-9.
5. Haroun HK, Sobhy MH, Abdelrahman AA. Arthroscopic Bankart repair with remplissage versus Latarjet procedure for management of engaging Hill-Sachs lesions with subcritical glenoid bone loss in traumatic anterior shoulder instability: a systematic review and meta-analysis. J Shoulder Elbow Surg, 2020, 29(10): 2163-2174.
6. Konda SR, Fisher N, Gage M, et al. Posterior fracture dislocation of the shoulder: A modified McLaughlin procedure. J Orthop Trauma, 2017, 31 Suppl 3: S36-S37.

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Chinese Journal of Reparative and Reconstructive Surgery

自体髂骨移植联合骨隧道修复固定肩胛下肌止点治疗三例陈旧性肩关节后脱位合并反 Hill-Sachs 损伤

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