复发性盂肱关节前脱位镜下Latarjet术:1例报告与综述

Arthroscopic Latarjet procedure for recurrent anterior glenohumeral dislocation: a case report and literature review

摘要:

复发性盂肱关节前脱位是较常见的肩部损伤，镜下 Latarjet 手术逐渐成为治疗合并关节盂骨缺损复发性盂肱关节前脱位的重要治疗方法，但该术式难度较大，学习曲线长。本文报告 1 例 23 岁复发性盂肱关节脱位患者，采用镜下 Latarjet 术+ Bankart 修补+Remplissage 手术治疗。术后 72 个月随访 CT 重建显示植骨块固定和愈合良好，在关节盂 5 点处形成有效遮挡， 但关节盂 3~4 点处骨量不足。查体见外展 90°~120°外旋位前恐惧试验仍为阳性，其余角度恐惧试验阴性。本文就镜下 Latarjet 术式的治疗机理、学习曲线和存在问题等进行综述，为临床医师提供参考。

Abstract:

Recurrent anterior glenohumeral dislocation is a common shoulder injury, which gradually become to be treated by ar- throscopic Latarjet procedure if complicated with glenoid defect. However, the arthroscopic Latarjet procedure is difficult in operation tech- nique with a long learning curve. In this paper, we reported a 23-year-old patient who received arthroscopic Latarjet procedure combined with Bankart repair and Remplissage procedure for recurrent glenohumeral dislocation. At 72 months postoperatively, the 3D CT reconstruc- tion revealed that the bone graft was fixed and healed well to cover the 5 o'clocks position of the glenoid effectively, whereas insufficient at 3 to 4 o'clocks points of the glenoid, and the patients presented positive apprehension test from 90° to 120° abduction, regardless of nega- tive apprehension test in the remaining range of abduction. In addition, this article reviews the treatment mechanism, learning curve and ex- isting problems of arthroscopic Latarjet procedure to provide reference for clinicians.