评估关节镜下改良自体髂骨骨块移植手术治疗肩关节脱位伴肩胛骨盂骨损伤患者的临床愈合、功能恢复和放射学结果。

采用单中心病例回顾研究。纳入标准：外伤性或复发性肩关节前向不稳伴明显的肩胛骨盂骨缺损；排除非创伤性或多向不稳定的患者。采用关节镜下改良的Eden-Hybinette手术，采用自体髂骨移植、双袢钛板加可吸收锚钉三角弹性固定的技术固定。术后对所有患者进行复发和恐惧实验评估。分别记录手术后3、6、12、24个月随访时的美国肩肘外科协会评分（American shoulder and elbow surgeons, ASES）、牛津大学肩关节不稳评分（Oxford shoulder instability score, OSIS）和肩不稳定评分（Rowe score for instability，ROWE）。分析患者肩胛骨盂骨的移植骨块愈合、并发症发生情况及肩关节活动范围。比较使用正态分布差异的配对t检验，否则使用非参数Wilcoxon秩和检验。

最终研究队列包括14例患者，平均年龄30岁，平均随访时间13个月，2例失访，截至最后一次随访，12例患者术后均无复发。术后最后一次随访时，患者ASES评分（84.0±8.5）分；OSIS评分（18.6±3.6）分；ROWE评分（90.4±5.4）分。与术前比，所有最终的术后功能的评分均显著增加，显示出了优异的结果。

关节镜下自体髂骨骨块移植采用双袢钛板加可吸收锚钉三角弹性固定的技术可以为肩关节前向不稳患者带来良好的临床效果和放射学结果。该改良技术可修复肩关节盂缺损以及恢复正常的肩部解剖结构。

As a common injury, anterior dislocation of the shoulder is estimated to have a lifetime incidence of 2% in the general population. The shoulder is a complex joint that sacrifices stability for the range of motion, and the anterior glenoid lip, the primary stabilizer of the glenohumeral joint, is most likely to be dislocated after injury. More than 95% of shoulder dislocation occurs in the anterior direction. The frequency of posterior and inferior dislocation is low, and the leading cause is trauma. Among anterior traumatic instability of shoulder joint, Bankart injury is the most common pathological change. Translation of the humeral head can lead to avulsion of the glenoid labrum of the scapula, which accounts for 4%-70% of anterior dislocation of the shoulder joint. In addition, there is evidence that each dislocation leads to a decrease in the width of the glenoid and an increase in the defect of the glenoid.

To evaluate clinical healing, functional recovery, and radiological outcomes in patients undergoing arthroscopic modified autologous iliac bone graft surgery for shoulder dislocation with glenoid bone injury.

A single-center case retrospective study with prospectively collected data. Inclusion criteria: traumatic or recurrent anterior shoulder instability with the significant glenoid bone defect; patients with nontraumatic or multidirectional instability were excluded. The modified Eden-Hybinette operation was adopted under arthroscopic and autologous iliac bone transplantation, double-loop titanium plate and triangular elastic fixation with absorbable anchor were used for fixation. All patients were evaluated for recurrence and fear level postoperatively. The American shoulder and elbow surgeons (ASES) , the Oxford shoulder instability score (OSIS) , and Rowe score for instability (ROWE) at 3, 6, 12, and 24 months after surgery were recorded, respectively. The graft healing, complications, and range of motion of the shoulder joint were analyzed. Values were compared using the paired t-test for differences in the normal distribution, otherwise the nonparametric Wilcoxon rank-sum test.

The final cohort included 14 patients with an average age of 30 years, and an average follow-up time of 13 months. 2 patients lost follow-up. At the last follow-up, 12 patients had no recurrence, and the ASES, OSIS, and ROWE scores were (84.0±8.5) point, (18.6 ±3.6) point, and (90.4±5.4) point, respectively. Compared with preoperative evalutions, the scores of all final postoperative functional scores increased significantly, showing excellent results.

Arthroscopic autologous iliac bone block transplantation with double-loop titanium plate and triangular elastic fixation with absorbable anchors can bring good clinical and radiological results for patients with anterior shoulder instability. This modified technique can be used for glenoid defects repair and normal shoulder anatomy restroration.