鏡視下 Bankart 修復術において経験した問題点と合併症について

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The purpose of this study was to evaluate the technical failure of and complications during an arthroscopic Bankart repair using suture anchors for recurrent anterior dislocation of the shoulder. This procedure was performed between January 2004 and August 2006 on 34 patients comprising 28 males and 6 females with an average age of 33.5 years old (range, 19-68); the patients were operated on in the beach-chair position under general anesthesia. In 1 case, an anchor was inserted in an incorrect position. In certain other cases, the strands were displaced from the anchors and were loosened. 2 anchors interfered with each other. After the induction of anesthesia, the patients were seated on a surgical table; their blood pressure at that time declined. During the procedure, the head of 1 patient shifted from its original position on the surgical table, depriving the head of support; this led to a practical dislodging of the tracheal tube. After the surgery, we observed both alopecia at the site of external occipital protuberance and axillary nerve palsy. All failures and complications occurred in the 1st 5 cases. The number of occurrences decreased with experience in further cases. After we performed the surgery in 20 cases, there were no failures or complications. Thus, performing the arthroscopic Bankart procedure using suture anchors is difficult for beginners. Based on these findings, generally, technical failure and complications occur in the first 5 cases in particular. Therefore, beginners should perform their first 5 cases of the arthroscopic Bankart procedure using suture anchors under the supervision of an expert surgeon.

鏡視下 Bankart 修復術において経験した問題点と合併症について

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