Objective To evaluate the role of glenoid osseous structure on anterior stabil ity of shoulder so as to provide the biomechanical basis for cl inical treatment. Methods Ten fresh shoulder joint-bone specimens were collected from10 adult males cadavers donated voluntarily, including 4 left sides and 6 right sides. The displacements of the specimens were measured at 0° and 90° abduction of shoulder joint by giving 50 N posterior-anterior load under the conditions as follows: intact shoulder joint, glenoid l ip defect, 10% of osseous defect, 20% of osseous defect, and repairing osseous defect. Results For intact shoulder joint, glenoid l i p defect, 10% of osseous defect, 20% of osseous defect, and repairing osseous defect, the displacements were (10.73 ± 2.93), (11.43 ± 3.98), (13.58 ± 4.86), (18.53 ± 3.07), and (12.77 ± 3.13) mm, respectively at 0° abduction of shoulder joint; the displacements were (8.41 ± 2.10), (8.55 ± 2.28), (9.06 ± 2.67), (12.49 ± 2.32), and (8.55 ± 2.15) mm, respectively at 90° abduction of shoulder joint. There was no significant difference between intact shoulder joint and others (P gt; 0.05) except between intact shoulder joint and 20% of osseous defect (P lt; 0.05). Conclusion When shoulder glenoid l ip defects or the glenoid osseous defect is less than 20%, the shoulder stabil ity does not decrease obviously, indicating articular l igament complex is not damaged or is repaired. When glenoid osseous defect is more than 20% , the shoulder stabil ity decreases obviously even if articular l igament complex is not damaged or is repaired. Simultaneous repair of glenoid osseous defect andarticular l igament complex can recover the anterior stabil ity of the shoulder.
Objective To review the progress in influence of bony structure of glenohumeral joint on the shoulder joint stabil ity. Methods Recent l iterature, concerning the influence factors of the shoulder joint stabil ity and the action of bony structure of the glenohumeral joint in the stabil ity of shoulder joint, was extensively reviewed and summarized. Results The specific factors which the bony structure of the glenohumeral joint influences the stabil ity of the shoulder joint are the conformity index, the shape of the glenohumeral joint, version angle, incl ination angle, and head shaft angle, etc. Conclusion Although the predecessor’s research experience and cl inical reports have prel iminarily determined therelationship between the bony structure of the glenohumeral joint and the stabil ity of the shoulder joint, it is necessary to further study in various aspects (including anatomy, biomechanics, and cl inical practice).
Objective To evaluate the results of open arthrolysis by elevated the lateral and medial collateral l igament-musculature complex from the supracondylar ridge of the humerus in treatment of post-traumatic elbow stiffness. Methods From March 2003 to December 2007, 33 patients with post-traumatic elbow stiffness were treated with open arthrolysis by elevated the lateral and medial collateral l igament-musculature complex from the supracondylar ridge of the humerus. There were 23 males and 10 females, aged 17-70 years old (mean 41.8 years old). According to Morrey, 15 caseswere extremely serious (less than 30° extension-flexion arc) and 18 cases were serious (30-60° extension-flexion arc). The range of motion of the elbow stiffness was (32.5 ± 28.9)° and the Mayo score was 51.9±13.1 before operation. All initial fractures were healed according to cl inical examination and X-rays films. All patients present with a post-traumatic elbow stiffness and the average period from initial trauma to elbow arthrolysis was 16.9 months (2-72 months). Results Wound infection occurred in 1 patient and cured after dressing change and anti-infectious treatment. The wounds healed by first intension in 32 cases. No patient showed sign of elbow instabil ity and debil itating pain. All patients were followed up 6 months to 5 years (mean 3.3 years). At last follow up, the Mayo score was 82.3 ± 14.4 and the range of motion of elbow stiffness was (108.8 ± 36.0)°; showing significant differences when compared with preoperation (P lt; 0.05). According to Mayo evaluation, the results were excellent in 11 cases, good in 18 cases, fair in 2 cases, and poor in 2 cases, the excellent and good rate was 87.88%. Thirty-one patients achieve satisfactory results. Two patients were not satisfied with the result, but the satisfactory results were achieved by a second arthrol ysis. Conclusion Open elbow arthrolysis and postoperative rehabil itation for patients with elbow stiffness can improve joint function and ensure the stabil ity of elbows.
【摘要】 目的 评价切开复位Herbert螺钉内固定加外支架治疗对亚急性和陈旧性舟状骨骨折的治疗效果。方法 2008年2月—2009年5月,对15例受伤后4周以上(平均7.6周)入院诊断为亚急性和陈旧性舟状骨骨折的患者均采用Herbert螺钉内固定加外支架治疗,术后随访5～16个月,平均12.5个月,按Gartland amp; Werley和改良Green amp; O’Brein评分系统进行评价治疗效果。结果 15例患者均进行有效随访,末次随访Gartland amp; Werley评分优8例,良5例,中2例,优良率为86.7％,改良Green amp; O’Brein评分优7例,良5例,中3例，优良率为80％。结论 此方法是治疗亚急性和陈旧性舟状骨骨折的有效措施,值得推广。