关节镜下肩袖间隙滑移技术修补巨大回缩型肩袖损伤  

Arthroscopic repair of massive contracted rotator cuff tears using a ＂slide＂ technique

作　　者：高庆峰[1] 何耀华[2] 王勇平[1] 赵金忠[1] 皇甫小桥[1] 杨星光[1] 刘闻欣[1] 王海明[1] 

机构地区：[1]苏州大学医学部,215006 [2]上海交通大学附属第六人民医院骨科

出　　处：《中华创伤骨科杂志》2013年第7期553-558,共6页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨关节镜下肩袖间隙滑移技术修补巨大回缩型肩袖损伤的疗效。方法2007年1月至2010年12月采用关节镜下肩袖间隙滑移技术修补21例巨大回缩型肩袖损伤患者，男8例，炙13例；年龄42～73岁，平均60．5岁；左侧7例，右侧14例。所有患者术后定期随访，末次随访时行X线及MRI检查。比较术前与末次随访时疼痛视觉模拟评分（VAS）、美国加利福尼亚大学洛杉矶分校（UCLA）评分及Constant—Murley评分，评价术后肩荚节活动范围和功能恢复情况。结果所有患并术后扶12～36个月（平均23．2个月）随访。术后无感染、伤口不愈合及肩关节感觉异常等并发症发生。末次随访时的X线片及MRI均显示肩关节在他良好，无明显肱骨头上移。术前VAS、UCLA及Constant—Murley评分平均分别为（4．6±1．3）、（8．7±2．5）、（38．1±7．7）分，末次随访时平均分别为（9．0±1．2）、（29．4±4．5）、（86．9±10．0）分，末次随访时较术前各项评分均有改善，差异均有统计学意义（P〈0．05）。结论关节镜下肩袖间隙滑移技术修复巨大㈦缩型肩袖损伤在疼痛、活动范围、肌力及功能恢复方面均有明显改善，叮获得较满意的临床效果。Objective To evaluate the ＂slide＂ technique used in anhroscopic repair of massive contracted rotator cuff tears. Methods Between January 2007 and December 2010, 21 patients （8 men and 13 women） uuderwent arthroscopic repair of massive contracted rotator cuff tears using the ＂ slide＂ technique. Their mean age was 60.5 years, ranging from 42 to 73 years. Seven cases had the tear on the left side and 14 on the right. All patients were followed up until the last time by X-ray and MRI evaluations. The postoperative range of motion （ROM） and functional recovery were evaluated by comparing the preoperative visual analog scale （VAS） pain score, University of California at Los Angeles （UCLA） and Constant-Murley scores with those at the last fullow-up. Results All patients were followed up for an average of 23.2 months （range, 12 to 36 months）. Good healing war achieved in all cases. The last follow-ups showed good alignment of the shoulder joint and no upper advancement of the humeral head. The average postoperative VAS, lJCLA and Consiant-Murley scores were respectively 4.6 ± 1. 3, 8.7 ± 2.5 and 38. 1 ± 7.7, significantly better than those at the last follow-up （9.0±1.2, 29. 4 ±4. 5 and 86. 9 ±10. 0 respectively） （P 〈 0.05） . No infection, nonunion or paresthesia of lhe shonhler joint was observed. Conclusion Arthro- scopic repair of massive contracted rotator cuff tears using the ＂slide＂ technique can lead to satisfactory clinical outcomes with respect to pain, ROM, muscle strenglh and funclional recovery.

关 键 词：肩关节 关节镜检查 肩撞击综合征 再手术 

分 类 号：R687.4[医药卫生—骨科学]