关节镜下手术松解治疗肩周炎的临床研究  

Arthroscopic release for treatment of frozen shoulder： a clinical observation

作　　者：桂鉴超[1] 王黎明[1] 顾湘杰[2] 蒋逸秋[1] 喻忠[1] 徐燕[1] 黄河[1] 王旭[2] 马昕[2] 

机构地区：[1]南京医科大学附属南京第一医院骨科,210006 [2]复旦大学附属华山医院骨科,上海

出　　处：《中华手外科杂志》2008年第1期30-33,共4页Chinese Journal of Hand Surgery

基　　金：南京市卫生科技重大科研课题基金资助项目（ZKX0217）

摘　　要：目的探讨关节镜下手术松解治疗肩周炎关节僵硬的临床效果。方法2000年7月至2006年4月，对20例肩周炎关节僵硬的患者，其中10例为特发性肩周炎，10例为创伤性肩周炎，采用关节镜下手术选择性松解旋转肌袖间隙、盂肱韧带、关节囊和肩峰下间隙等进行治疗。并用VAS（visual analog painscale）疼痛评分系统和改良美国肩肘关节外科协会评分系统（（modified american shoulder and elbow society score，MASES）进行疗效评价。结果全部患者获得13～73个月（平均28．1个月）的随访。术后肩关节活动度、VAS和MASES评分均较术前明显改善（P〈0．01），优7例，良10例，一般3例，优良率为85％，未发生任何手术并发症。特发性肩周炎患者在肩关节外展活动度、VAS和MASES评分的改善方面均优于创伤性肩周炎，两组差异有统计学意义（P〈0．01、P〈0．05和P〈0．01）。结论关节镜下松解术是治疗肩周炎关节僵硬的首选方法。肩周炎的手术疗效不但与病因有关，还与术前肩关节僵硬的程度有关。Objective To report the result of arthroseopie release for treatment of frozen shoulder. Methods From July 2000 to April 2006,20 cases of frozen shoulder with stiffness were treated. Ten of these eases were idiopathic frozen shoulders, while the other 10 eases were traumatic frozen shoulders. Arthroseopie release of the rotator interval, glenohumeral ligament, capsule and subacromical space were selectively done during the operations. The VAS （visual analog pain scale） and the MASKS （modified American Shoulder and Elbow Society Score） were used for outcome evaluation. Statistical analysis was performed by SPSS 10, and the significance level was set at less than 0.05. Results All eases were followed-up for an average of 28.1 months（range, 13 to 73 months）. The range of motion of the shoulder, VAS, and MASKS scores were improved significantly when compared with the preoperative level（ P 〈 0.01）. There were 7 excellent, 10 good, and 3 fair eases according to MASKS, and an 85% excellent and good rate was achieved. No surgery-related eomplications occurred. The idiopathic frozen shoulder eases had greater improvement for the shoulder abduction movement, VAS scores and MASKS scores than the traumatic eases （ P 〈 0.01, P 〈 0.05, P 〈 0.01 respectively）. Conclusion Arthroscopie release is the tratment of choice for frozen shoulder stiffness. The result not only relates to the pathogenesis, but also relates to the extent of preoperative stiffness.

关 键 词：肩关节 滑囊炎 关节镜 关节囊松解 

分 类 号：R687[医药卫生—骨科学]