关节镜下穿肌腱技术治疗关节侧部分肩袖损伤  

Arthroscopic Treatment for Partial Articular Surface Tendon Avulsions by the Transtendon Repair Technique

作　　者：王微[1] 李剑[1] 李红川[1] 康汇[1] 

机构地区：[1]西安交通大学附属红会医院运动医学肩肘病区,陕西西安710054

出　　处：《实用骨科杂志》2017年第2期97-99,104,共4页Journal of Practical Orthopaedics

摘　　要：目的研究关节镜下穿肌腱技术治疗关节侧部分肩袖损伤的方法与疗效。方法收集我科自2013年1月至2015年1月治疗的关节侧部分肩袖损伤24例患者的资料,男8例,女16例;年龄30~66岁,平均47.5岁;右侧10例,左侧14例。11例为直接暴力外伤,13例无明显外伤史,全部为闭合性损伤。所有患者均在肩关节镜下探查肩袖关节侧部分肩袖损伤,予以关节腔清理后进入肩峰下间隙,穿肌腱在足印区植入带线锚钉,打结修补损伤肩袖,重建肩袖的完整性。术后根据患者情况进行个体化康复锻炼。结果所有患者均获随访,平均随访18个月(12~24个月)。术后所有患者均未出现感染、肩关节功能明显受限等现象。采用美国肩肘外科(American shoulder and elbow surgeons,ASES)评分标准和Constant-Murley评分标准对手术前后肩关节功能进行评分,ASES评分由术前(50.5±6.8)分提高到终末随访时(88.9±4.52)分,Constant-Murley评分由术前(80.4±3.0)分提高到终末随访时(97.0±3.52)分,P<0.001,差异有统计学意义。结论对于≥50%的关节侧部分肩袖损伤,穿肌腱技术修补关节侧部分肩袖损伤可重建足印区解剖,恢复肩袖完整性,是一种有效的治疗方法。Objective To study the method and efficacy of arthroscopic treatment for partial articular surface tendon avulsions（PASTA）.Methods We collecting the data of 24 patients who had PASTA from 2013.1to 2015.1in our department.There were 8males and 16 females whose age were from 30 to 66years,the average age was 47.5years.The10 cases were the right side and 14 cases were the left side.The 11 cases were caused by direct traumatic violence and 13 cases were no history of trauma,all patients were closed injury.All patients were treated by arthroscopic exploratory.We cleaned up the joint cavity and got into the Subacromialgap,implanted the anchors with line in the footprint by the transtendon technique,then knot and repaired the rotator cuff injury,rebuild the integrity of the rotator cuff.Individualized exercise was performed based on the patient＇s conditionpostoperative.Results There were no infection,no limited function of the shoulder with an average follow-up of 18months（12-24months）.We scored the shoulder function before and after surgery by the American Shoulder and Elbow Surgery（ASES）score and Constant-Murley score for shoulder function.There was statistically significant different between the scores before and after operation,analyzed the results of shoulder function between preoperative and postoperative with paired t-test（α=0.05）by the statistical software of SPSS 14.0,α=0.05,analytical results were shown：P〈0.001,andstatistically significant.Conclusion.Conclusion For PASTA that was more than 50%,repairing the PASTA by thetranstendon repair technique which can rebuild thefootprint anatomyand restore the integrity of the rotator cuff,is an effective method for treatment.

关 键 词：关节镜 关节侧部分肩袖损伤 穿肌腱技术 

分 类 号：R684[医药卫生—骨科学]