关节镜下360°松解治疗原发性冻结肩  

Arthroscopic 360 degree release for the treatment of primary frozen shoulder

作　　者：袁锋[1] 蔡俊丰[1] 马敏[1] 罗树林[1] 周炜[1] 卢亮宇[1] 潘张毅 曾文[1] 尹峰[1] 

机构地区：[1]上海同济大学附属东方医院关节与骨病专科,200120

出　　处：《中华肩肘外科电子杂志》2016年第2期76-81,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：上海市科委课题资助项目(15411968700);上海市卫生局课题资助项目(20134404);浦东新区卫生系统优秀青年医学人才培养计划(PWRq2014-35)

摘　　要：目的：观察关节镜下360°松解治疗原发性冻结肩的临床疗效。方法自2010年10月至2012年10月上海同济大学附属东方医院就诊的原发性冻结肩患者86例,其中男性36例,女性50例,平均年龄（60.5±8.0）岁（45～78岁）,核磁共振均未见肩袖、盂唇等肩关节损伤。经过正规保守治疗6个月以上无效。86例患者均在关节镜下行360°松解,所有患者于治疗前后采用 Constant 肩关节功能评分和视觉模拟评分（visual analogue scale,VAS）进行疗效评估。结果手术均顺利完成,切口均Ⅰ期愈合,无相关并发症发生。86例患者均获随访,平均随访时间（36.6±6.7）个月（24～48个月）。术后12个月 Constant 肩关节功能评分为（92.7±2.7）分,与术前（55.9±5.5）分比较,差异有统计学意义（t =-60.522,P 〈0.01）。术后12个月肩关节疼痛 VAS 评分为（0.4±0.7）分,与术前（8.3±1.1）分比较,差异有统计学意义（t =-58.928,P 〈0.01）。术后未出现继发性肩关节不稳。结论关节镜下360°松解术治疗冻结肩具有良好的临床疗效,该疗法具有创伤小、恢复快、安全、可靠等优点。Background Frozen shoulder is a common cause for joint pain and disability in affected patients.The predilection age is 50 years,the incidence in females is slightly higher than that in males,and can be seen more often in manual workers.The function of shoulder joint could be affected seriously by this disease without appropriate treatment.Pseudo frozen shoulder often occurred after soft tissue trauma such as rotator cuff or limited activity caused by pain in the shoulder,thus cause misdiagnosis of frozen shoulder.Primary frozen shoulder refers to presence of active and passive activity limitation at multiple planes without clear history of shoulder disorders.Patients with primary frozen shoulder used to adopt conservative treatments like general functional exercise,medication, plasters,physical therapy,acupuncture and moxibustion and cupping,the general course will last for 2-3 years,and the curative effect in many patients is poor.In this study,patients with primary frozen shoulder were treated through arthroscopy release by 360 degree,course of the disease was shorten by this operation,and the effect of treatment was improved.From October 2010 to October 2012,a total of 86 patients with primary frozen shoulder were hospitalized to received arthroscopic arthrolysis by 360 degree,the curative effect was satisfactory,and it is reported as follows.Methods General information：A total of 86 patients with primary frozen shoulder were admitted into specialist department of joint and bone disease of Shanghai East Hospital affiliated to Tongji University from＆amp;nbsp;（October 2010 to October 2012,there were 36 males and 50 females,aged from 45 to 78 years,the mean age was （60.5±8.0）years,left shoulder involved in 42 cases and right shoulder involved in 44 cases,the course duration was 3-24 months,all patients suffered from shoulder joint pain without incentives and limited activity of the shoulder,the symptoms persisted and worsen.）The effect of conservative treatment was not obvious.Score of the shoulder

关 键 词：关节镜 松解 原发性冻结肩 

分 类 号：R687.4[医药卫生—骨科学]