■已经描述了肩关节锁定后脱位(LPDS)的多种治疗方案,包括改良的McLaughlin程序.这次审查的目的,因此,我们将对文献进行系统回顾,以综合有关接受改良McLaughlin手术治疗LPDS的患者的临床和影像学结果的可用数据报告。
■对PubMedCentral的系统评价,MEDLINE,Embase,Scopus,WebofScience,和Cochrane图书馆数据库从成立到2023年1月进行。纳入了接受改良McLaughlinLPDS手术的患者的临床和影像学结果的结果研究。注意到术后并发症和反复发作的不稳定性。
■最初确定了总共1322项研究,其中9人被认为有资格纳入我们的审查。在纳入的研究中,共97名肩膀(96名患者),平均年龄37.7岁(范围,26-51)被确定。最常见的损伤机制包括创伤,癫痫发作,和电死。反向Hill-Sachs病变的大小范围为肱骨头关节面的20%至50%。在最后的后续行动中,加州大学洛杉矶分校的加权平均肩部得分,Constant-MurleyScore,美国肩肘外科医师肩谱,疼痛的视觉模拟量表为29分(范围,27-31),75(范围,65-92),92(范围,83-98),和1.9(范围,1-2.4),分别。在一项仅报告急性期治疗的研究中,术后Constant-Murley评分和加利福尼亚大学洛杉矶分校评分最高。加权平均术后前屈,绑架,外部旋转,和内部旋转为154°(范围,102-176),144°(范围,118-171),64°(范围,44-84),和47°(范围,42-56),分别。在最后一次随访中,所有患者均注意到较小结节的骨整合。一名患者(占队列的1.0%)发生了术后并发症;通过手术切除成功治疗了螺钉迁移。在两名癫痫患者中发现了复发性不稳定性(占队列的2.1%)。
■围绕将改良的McLaughlin程序用于LPDS的文献仍然很少。这篇综述表明,该手术与良好的临床和影像学结果相关,并发症和复发性不稳定的总体发生率低。特别是当从受伤到手术的时间最小化时。这些发现表明,在患有LPDS和肱骨头关节面20%至50%之间的Hill-Sachs反向病变的患者中,改良McLaughlin手术是一种安全有效的治疗选择.
UNASSIGNED: Multiple treatment options for locked posterior dislocation of the shoulder (LPDS) have been described, including the modified McLaughlin procedure. The purpose of this review, therefore, was to perform a systematic review of the literature to synthesize the available data reporting on the clinical and radiographic outcomes of patients undergoing the modified McLaughlin procedure for the treatment of LPDS.
UNASSIGNED: A systematic review of the PubMed Central, MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library databases from inception through January 2023 was performed. Outcomes studies reporting on clinical and radiographic outcomes in patients undergoing the modified McLaughlin procedure for LPDS were included. Postoperative complications and episodes of recurrent instability were noted.
UNASSIGNED: A total of 1322 studies were initially identified, of which 9 were deemed eligible for inclusion in our review. Among included studies, a total of 97 shoulders (96 patients) with a mean age of 37.7 years (range, 26-51) were identified. The most common mechanisms of injury included trauma, seizure, and electrocution. Reverse Hill-Sachs lesions ranged in size from 20% to 50% of the humeral head articular surface. At final follow-up, the weighted mean University of California at Los Angeles shoulder score, Constant-Murley Score, American Shoulder and Elbow Surgeons shoulder score, and visual analog scale for pain score were 29 (range, 27-31), 75 (range, 65-92), 92 (range, 83-98), and 1.9 (range, 1-2.4), respectively. Postoperative Constant-Murley Score and University of California at Los Angeles scores were highest in the one study reporting exclusively on treatment during the acute period. Weighted mean postoperative forward flexion, abduction, external rotation, and internal rotation were 154° (range, 102-176), 144° (range, 118-171), 64° (range, 44-84), and 47° (range, 42-56), respectively. Osteointegration of the lesser tuberosity was noted in all patients at the final follow-up. Postoperative complications occurred in one patient (1.0% of cohort); a screw migration successfully treated with operative removal. Recurrent instability was noted in two epileptic patients (2.1% of cohort).
UNASSIGNED: The literature surrounding the use of the modified McLaughlin procedure for LPDS remains sparse. This review demonstrates that this procedure is associated with favorable clinical and radiographic outcomes with overall low rates of complication and recurrent instability, especially when the time from injury to surgery is minimized. These findings illustrate that in patients presenting with LPDS and a reverse Hill-Sachs lesion between 20% and 50% of the humeral head articular surface, the modified McLaughlin procedure is a safe and effective treatment option.