穿线法套索固定冈上肌腱关节侧部分撕裂  

Threading lasso for repairing partial articular-surface supraspinatus tendon tears

作　　者：陈孙裕 肖展豪 王建坤 CHEN Sun-yu;XIAO Zhan-hao;WANG Jian-hun(Department of Sports Injury,Fuzhou Second Hospital,Xiamen University,Fuzhou 350007,China)

机构地区：[1]厦门大学附属福州第二医院运动损伤科,福建福州350007

出　　处：《中国矫形外科杂志》2021年第16期1505-1507,共3页Orthopedic Journal of China

基　　金：福建省卫计委推广项目(编号:2014022)。

摘　　要：[目的]介绍穿线法套索固定冈上肌腱关节侧部分撕裂的手术技术和初步临床结果。[方法] 2016年3月—2018年10月,对25例冈上肌腱关节侧部分撕裂患者采用关节镜下修复术,镜下探查肩盂关节及肩峰下间隙,必要时行适度肩峰成形,于盂肱关节内观察,腰穿针通过前外侧入路经冈上肌腱滑囊侧表面穿过关节侧撕裂部分近侧端两侧,将高强度线引入,形成套索,线尾分别穿出冈上肌腱滑囊侧,采用外排锚钉将高强度线固定于肱骨大结节。[结果]所有患者均顺利完成手术,术后无并发症发生。术后肩关节疼痛及活动功能均明显改善,VAS评分由术前(5.43±1.21)分显著下降至末次随访的(1.15±0.83)分(P<0.05);ASES肩关节功能评分由术前(51.64±6.47)分显著增加至末次随访时的(89.32±5.27)分(P<0.05);UCLA评分由术前(17.83±3.56)分显著增加至末次随访时的(32.31±1.45)分(P<0.05)。[结论]对于冈上肌腱关节侧部分损伤的患者,采用关节镜下穿线法套索固定,能恢复肌腱张力,改善患肢功能,是一种有效的治疗方法。[Objective] To introduce the surgical technique and preliminary clinical results of threading lasso for repairing partial articular-surface supraspinatus tendon tear. [Method] From March 2016 to October 2018, 25 patients underwent arthroscopic repair of partial articular-surface supraspinatus tendon tear. The glenoid joint and subacromial space was explored under the arthroscope, and moderate acromioplasty was conducted if necessary. Observing the glenohumeral joint, two lumbar puncture needles were introduced by the anterolateral portal, passed through both sides of the proximal end of the tendon to joint side from the bursa surface of the supraspinatus tendon. The high-strength thread was introduced to form a lasso with the thread tails out the bursa side of the supraspinatus tendon. Finally, the highstrength thread was fixed to the greater tuberosity of the humerus with outer row of anchors. [Results] The operation was successfully completed in all patients, with no complications after operation. The shoulder symptoms and movement function were significantly improved postoperatively. The VAS score decreased significantly from(5.43±1.21) preoperatively to(1.15±0.83) at the latest follow-up(P<0.05);the ASES score significantly increased from(51.64±6.47) preoperatively to(89.32±5.27) points(P<0.05);and the UCLA scores were significantly increased from(17.83±3.56) before surgery to(32.31±1.45) points at the latest follow-up(P<0.05). [Conclusion] The arthroscopic threading lasso does restore the tension of the tendon and improve the function of the affected limb, is an effective treatment method for partial articular-surface supraspinatus tendon tear.

关 键 词：关节镜术 肩袖部分损伤 修复 

分 类 号：R687.4[医药卫生—骨科学]