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

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。

Clinical Efficacy of Arthroscopic Surgery and Conservative Treatment of Initial Anterior Shoulder Dislocation in Young People

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.