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首页> 外文期刊>Journal of shoulder and elbow surgery >Open posterior stabilization for recurrent posterior glenohumeral instability.
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Open posterior stabilization for recurrent posterior glenohumeral instability.

机译：开放性后路稳定术可复发性后肱骨肱骨不稳。

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摘要

Open posterior capsular shift is used for posterior glenohumeral instability that has failed nonoperative treatment. Few series have fully evaluated the outcome after open posterior stabilization. The purpose of this series was to evaluate the clinical and radiographic outcome after open posterior stabilization of the shoulder. Preoperative and intraoperative factors were analyzed with regard to their impact on results. Forty-eight consecutive shoulders were identified that had undergone primary open shoulder stabilization by use of open posterior capsular shift. Of the shoulders, 4 were lost to follow-up, resulting in a study group of 44 shoulders in 41 patients. Shoulders were evaluated at a range of 1.8 to 22.5 years after surgery by use of the L'Insalata shoulder form, Short Form-36 (SF-36), and a subjective shoulder rating in 44 shoulders. Thirty-nine shoulders were evaluated by physical examination, and thirty-seven underwent radiographic examination. A recurrence of posterior instability occurred in 8 shoulders (19%). Of the patients, 84% were satisfied with the current status of their shoulder. The mean L'Insalata score was 81.25+/-17.8 points, the mean SF-36 physical component score was 50.81+/-7.87, and the mean mental component score was 53.82+/-7.55. Significantly poorer satisfaction and outcome scores were seen in shoulders found to have a chondral defect at the time of stabilization and in patients aged greater than 37 years at the time of surgery. No progressive radiographic signs of glenohumeral arthritis were seen up to 22 years after surgery. Open posterior shoulder stabilization is a reliable procedure for treating significant posterior instability without causing arthritic changes. Patients found to have chondral damage within the shoulder and older patients were found to have less success after stabilization.
机译：开放性后囊移位用于非手术治疗失败的后肱骨肱骨不稳。很少有系列文献对开放性后路稳定术后的结果进行了全面评估。本系列文章的目的是评估肩膀后路稳定后的临床和影像学结果。分析术前和术中因素对结果的影响。通过使用开放性后囊移位，鉴定出已经经历了主要开放性肩膀稳定的四十八个连续肩膀。在肩部中，有4个因随访失败，导致研究组41例患者中有44个肩部。通过使用L'Insalata肩部形式，Short Form-36（SF-36）和44个主观肩膀评级，在手术后1.8到22.5年的范围内评估肩膀。通过体格检查评估了39个肩膀，并进行了X线检查。 8个肩膀（19％）发生后部不稳定性复发。在这些患者中，有84％的患者对肩膀的当前状态感到满意。 L'Insalata平均分是81.25 +/- 17.8分，SF-36身体平均分是50.81 +/- 7.87，心理平均分是53.82 +/- 7.55。在稳定时发现肩部有软骨缺损的肩膀以及手术时年龄超过37岁的患者，满意度和结局评分均明显降低。手术后直至22年，均未见盂肱关节炎的放射影像学表现。开放式后路肩稳定术是治疗明显的后路不稳而不引起关节炎改变的可靠方法。发现肩部软骨损伤的患者，稳定后发现老年患者的成功率较低。

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