Comparative Analysis Of Arthroscopy And Conservative Treatment Of Primary Anterior Dislocation Of Shoulder Joint With Injury

Objective:The results of arthroscopy and conservative treatment before and a fter primary anterior dislocation of shoulder were recorded and compared.Methods:From September 2016 to April 2018,33 patients with primary anterior dislocation of shoulder joint combined with injury were admitted to our department,with an average age of 55.9 years,its average follow-up time of 12.6 months(8 to 16 months).All the 33 cases were the first anterior dislocation of shoulder joint,and the emergency cases were treated with manual reduction of shoulder joint closure,postoperative fixation of abductor support and MRI examination of the affected side of shoulder joint,all of which indicated rotator cuff tear of different degrees(avulsion fracture of the greater tuberosity of the humerus),part of them were combined with Bankart injury and SLAP injury(included avulsion fracture of the greater tuberosity).The 33 patients were divided into the operation group and the conservative group according to the different treatment methods.18 patients in the operation group received arthroscopic surgery and 15 patients in the conservative group received conservative treatment.The average duration of injury in the operation group was 12.5 days(8-16 days),were given surgery and conservative treatment.Before and after treatment,the range of motion of shoulder joint(ROM),VAS pain score,American association of shoulder and elbow surgeons score(ASES score),UCLA score and Rowe score were respectively applied to evaluate shoulder joint function.Meanwhile,the number of cases of redislocation of shoulder joint and the nu mber of cases of secondary frozen shoulder were recorded,and the res ults were statistically and analyzed.Results:33 patients were completed follow-up,the average of follow-up time was 12.6 months(8 to 16 months),record the two groups before treatment scope of shoulder joint activity(ROM),VAS pain score,American society of shoulder elbow surgeons rating(ASES score),UCLA score and Rowe,grading,comparative had no obvious difference(P>0.05),the last follow-up treatment scope of shoulder joint activity :external was 65.1 ±1.3 °,abduction rotation was 151.0 ±3.1 °,antexion rotation was 144.8 ± 3.5 °;VAS pain score was 2.0±1.8 points;UCLA score was 31.3±1.3 points;Rowe score was 89.5±2.5;ASES score 90.8±1.5points;Redislocation of shoulder joint occurred was 0 cases,and the redislocation rate was 0%;The incidence of secondary frozen shoulder was 0% in 0 cases.Range of motion of shoulder joint in the conservative group: external rotation 53.1±4.8°,abduction rotation was 137.4±2.3°,antexion rotation was 130.2±2.6°;VAS pain score was 3.1±1.1 points;UCLA score was 17.7±1.1 points;Rowe score was 35.2±2.4 points;The ASES score was 58.3±3.7 points.Two cases of shoulder joint redislocation occurred,and the redislocation rate was 13.3%.The incidence of secondary frozen shoulder was 6.7% in 1 case.Statistical analysis showed the results of the two groups after treatment were statistically significant(P < 0.05).The effect of operation group was better than that of conservative group.Conclusion:First merger after anterior dislocation of shoulder joint injury patients in the early diagnosis of early application of arthroscopic surgery to repair the damage of the organizational structure,more than conservative treatment can obtain satisfactory effect,promote patients with shoulder joint function recovery,avoid left shoulder pain,shoulder joint a dhesion,improve the activity,reduce the incidence of shoulder joint dislocation and secondary frozen shoulder incidence.