镜下边缘增强缝线桥全层修复肩袖分层撕裂  

Arthroscopic edge-enhanced suture bridge for full-thickness repair of delaminated rotator cuff tear

作　　者：张立智 胡孙君 杜守超 Rujan Tuladhar 卫禛 熊文峰 张世民 ZHANG Li-zhi;HU Sun-jun;DU Shou-chao;Rujan Tuladhar;WEI Zhen;XIONG Wen-feng;ZHANG Shi-min(Yangpu Hospital Affiliated to Tongji University,Shanghai 200090,China)

机构地区：[1]同济大学附属杨浦医院骨科,上海200090

出　　处：《中国矫形外科杂志》2021年第10期925-928,共4页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81572218);上海市自然科学基金项目(编号:13ZR1439100);上海市卫生局局级课题面上项目(编号:20124303)。

摘　　要：[目的]介绍关节镜下边缘增强缝线桥全层修复肩袖分层撕裂的手术技术与初步临床疗效。[方法] 2017年8月~2019年04月对21例肩袖分层撕裂患者进行镜下修复。镜下探明肩袖撕裂的部位,并进行清创,磨钻打磨肱骨大结节,直至磨平、松质骨渗血为止。复位分层肩袖,应用单排固定或内排打结固定加强缝合固定肩袖撕裂两端的止点,全层修复分层撕裂,于足印区缝线桥压紧固定整体肩袖。[结果]所有患者均顺利手术,无感染等并发症。随访时间至少12个月,UCLA评分由术前的(13.86±1.77)分提高到最终随访时的(32.62±1.53)分,Constant-Murley评分由术前(35.05±4.25)分提高到(92.67±3.86)分(P<0.001)。[结论]镜下边缘增强缝线桥全层修复能很好地恢复分层肩袖的整体性和完整性,防治肩袖进一步撕裂,增强肩袖整体的初始强度,改善患者关节功能。[Objective] To introduce surgical technique and preliminary clinical outcomes of arthroscopic edge-enhanced suture bridge for full-thickness repair of delaminated tears of the rotator cuff. [Methods] Twenty-one patients received arthroscopic repair for delaminated rotator cuff tear from August 2017 to April 2019. In the operation, the delaminated tears of the rotator cuff were identified and debrided under arthroscope, and then the greater tuberosity of the humerus was prepared with a burr and smoothed out until cancellous bone exposed with bleeding. After that, the delaminated tears of the rotator cuff were reduced, single row fixation or inner row knotted fixation was used to fix the two ends of the rotator cuff tear. Full-thickness repair of the delaminated rotator cuff was achieved by pressing the cuff with suture bridge on the foot print area. [Results] All patients underwent successful operation without complications, such as infection.The patients were followed up for more than 12 months. The UCLA score increased significantly from(13.86±1.77) preoperatively to(32.62±1.53) at the latest follow-up(P<0.05), in addition, the Constant-Murley score increased significantly from(35.05±4.25) preoperatively to(92.67±3.86) at the last follow-up(P<0.05). [Conclusion] The arthroscopic enhanced suture bridge for full-thickness repair of delaminated rotator cuff tear does restore the integrity of the rotator cuff, enhance the overall strength of the rotator cuff, prevent tearing progression and retear, and improve the joint function.

关 键 词：肩袖 分层撕裂 全层缝合 边缘增强缝线桥 

分 类 号：R683.41[医药卫生—骨科学]