关节镜下两种不同松解方法治疗原发性冻结肩的临床疗效比较  

Comparison of clinical efficacy of two different arthroscopic release methods for the treatment of primary frozen shoulder

作　　者：徐鸿尧 戴志宏[1] 邹相杰 夏鹏程 黄河[1] XU Hong-yao;DAI Zhi-hong;ZOU Xiang-jie;XIA Peng-cheng;HUANG He(Department of Sports and Joint Surgery,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing210006,Jiangsu,China)

机构地区：[1]南京医科大学附属南京医院南京市第一医院运动关节科,江苏南京210006

出　　处：《中国骨伤》2020年第12期1101-1105,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:比较关节镜下使用Inside-out技术与Outside-in技术治疗原发性冻结肩的临床疗效。方法:自2015年4月至2019年7月,65例原发性冻结肩患者按照治疗方法不同分为观察组和治疗组。观察组32例,男14例,女18例;年龄48~64(54.82±5.35)岁;右侧18例,左侧14例;病程4~10(7.76±1.19)个月;采用Outside-in技术松解治疗。对照组33例,男16例,女17例;年龄45~62(54.64±4.16)岁;右侧18例,左侧15例;病程5~9(7.65±1.24)个月;采用Inside-out技术松解治疗。比较两组患者手术时间、住院天数及住院费用,比较手术前后Constant-Murley功能评分及术后1个月肩关节活动度评价临床疗效。结果:65例获得随访,时间9~17(11.34±2.24)个月。两组患者住院天数及住院费用比较差异无统计学意义(P>0.05),观察组手术时间短于对照组(P<0.05);两组患者术后Constant-Murley功能评分较术前提高(P<0.05),但两组间Constant-Murley功能评分比较差异无统计学意义(P>0.05);两组患者术后1个月肩关节外展、后伸、前屈、外旋活动度比较差异无统计学意义(P>0.05),但观察组内旋功能较对照组改善(P<0.05)。结论:两种关节镜下松解方案在治疗原发性冻结肩中都取得了满意的疗效,肩关节功能与疼痛程度都得到了有效的改善。Outside-in从外向内松解技术更为直接,操作更简单,手术时间短,在原发性冻结肩的松解操作时有一定优势。Objective:To compare clinical effects of inside-out technique and outside-in technique for the treatment of idiopathic frozen shoulder under arthroscopy.Methods:From April 2015 to July 2019,65 patients with primary frozen shoulder were divided into observation group and control group according to different treatment methods.In observation group,there were 32 cases,including 14 males and 18 females,aged 48 to 64(54.82±5.35)years old,18 cases on the right side and 14 cases on the left side.The course of disease was 4 to 10(7.76±1.19)months.The patients were treated with outside in technique.In control group,there were 33 cases,16 males and 17 females,aged 45 to 62(54.64±4.16)years old,18 cases on the right side and 15 cases on the left side.The course of disease was 5 to 9(7.65±1.24)months.The patients were treated with inside out technique.The operation time,hospitalization days and treatment cost were compared between the two groups.Constant-Murley function score before and after the operation and the shoulder joint range of motion one month after operation were compared to evaluate the clinical efficacy.Results:All 65 patients were followed up for 9 to 17 months with an average follow-up time of(11.34±2.24)months.Compared with control group,operation time in observation group was shorter[(55.53±10.23)min vs(85.58±13.39)min],and functional scores of Constant-Murley after surgery were significantly changed in both groups compared with that before surgery(P<0.05).There was no significant difference in functional scores of Constant-Murley between two groups(P>0.05).There was no significant differences in hospitalization time and treatment cost between two groups(P>0.05),and there was no significant difference in shoulder abduction,extension flexion and rotation activity between two groups(P>0.05),but internal rotation of observation group was improved compared with that of control group(P<0.05).Conclusion:The two arthroscopic release schemes have achieved satisfactory results for the treatment of primary froz

关 键 词：关节镜 关节囊松解 肩关节 肩凝症 

分 类 号：R686.5[医药卫生—骨科学]