部队官兵复发性肩关节脱位诊治及疗效评估

目的探讨基层部队官兵复发性肩关节脱位的原因、治疗方法及预后。方法回顾分析我院骨科2000年8月—2012年8月期间收治的确诊为复发性肩关节脱位的27例官兵的临床资料,并采用Rowe评分量表和牛津大学肩关节不稳评分量表(OSIS)对随访患者进行评估。结果 25例患者接受手术,术后21例完成随访,随访时间为6～72(46.7±3.76)个月。15例肩关节功能恢复正常,3例外旋、上举轻度受限,2例脱位复发,1例存在活动疼痛。手术前后Rowe评分为(38.1±14.8)分和(85.8±14.6)分(P<0.01)。术后优良率较术前提高76.1%;手术前后OSIS评分为(42.7±6.4)分和(19.7±5.8)分(P<0.01)。结论初次脱位后全面的诊断、充足的固定时间、合适的手术方式选择以及术后系统的康复锻炼是预防和治疗部队官兵复发性肩关节脱位的关键环节。

Clinical observation on recurrent shoulder joint dislocation among soldiers

Objective To study the cause,treatment and prognosis of recurrent shoulder joint dislocation among soldiers.Methods Clinical data of 27 uniformed patients diagnosed as recurrent shoulder joint dislocation and admitted to the hospital between August 1st,2000 and August 1st,2012 were retrospectively reviewed,and patients sticking to follow-up visit were assessed by Rowe shoulder assessment and Oxford Shoulder Instability Score(OSIS).Results Twenty-five patients received operation.21 patients were followed-up.The following up period ranged from 6-72 months with an average of(46.7 ± 3.76) months.And 15 patients recovered to pre-injury activity levels after operation,3 had a little restricted activity in extorsion and upthrow,2 had recurrent dislocation and 1 suffered from shoulder pain after the procedure.Significant improvement was detected by Rowe score(preop.38.1 ± 14.8 vs postop.85.8 ± 14.6,P < 0.01),with an increase in good and excellent score rating of 76.1%.OSIS was also satisfying(preop.42.7 ±6.4 vs postop.19.7 ±5.8,P <0.01).Conclusion Comprehensive diagnosis after initial injury,adequate fixation,appropriate selection of surgical approach and systematic postoperative rehabilitation training are the key links in prevention and treatment of recurrent shoulder joint dislocation among soldiers.