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中华肩肘外科电子杂志 ›› 2025, Vol. 13 ›› Issue (04) : 193 -196. doi: 10.3877/cma.j.issn.2095-5790.2025.04.001

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创伤性肩关节后脱位的手术技术进展
肖济阳, 任东(), 邢丹谋, 王欢, 陈焱, 张明   
  1. 430033 武汉市第四医院手显微及修复重建外科中心
  • 收稿日期:2025-10-05 出版日期:2025-11-05
  • 通信作者: 任东

Progress in surgical techniques for treating traumatic posterior shoulder dislocations

Jiyang Xiao, Dong Ren(), Danmou Xing   

  • Received:2025-10-05 Published:2025-11-05
  • Corresponding author: Dong Ren
引用本文:

肖济阳, 任东, 邢丹谋, 王欢, 陈焱, 张明. 创伤性肩关节后脱位的手术技术进展[J/OL]. 中华肩肘外科电子杂志, 2025, 13(04): 193-196.

Jiyang Xiao, Dong Ren, Danmou Xing. Progress in surgical techniques for treating traumatic posterior shoulder dislocations[J/OL]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2025, 13(04): 193-196.

肩关节后向脱位是一类少见但可造成严重关节活动障碍的损伤,约占全部肩关节脱位的1/20。目前临床上对肩关节后脱位诊治尚未形成普遍共识,本文旨在通过回顾既往文献,探讨创伤性肩关节后脱位各类手术技术适应证、临床效果及新技术进展。肱骨小结节截骨移位固定术(改良McLaughin技术)是填充中等量肱骨头缺损最常用的手术方式,能有效避免再发脱位,自体/同种异体骨软骨移植的解剖性关节面重建手术可以准确恢复关节形态,更适用于较大缺损面积的重建,部分研究提示术后骨性关节炎的退行性变发生率较高。对肱骨头压缩缺损超过50%的大面积反Hill-Sachs损伤、慢性锁定性脱位、合并肩盂侧损伤缺损则适用肩关节置换术,反肩置换术理论上稳定性更好。肩关节镜技术是近年来发展迅猛的手术趋势,具有微创优势,可同时修复后关节囊盂唇损伤,尤其适用于急性脱位支撑复位的类型。根据患者年龄、功能需求、脱位时间长短及缺损面积不同选用合适的手术技术,可取得良好的肩关节功能恢复。

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