肩关节镜的双后侧辅助入路关节囊松解治疗冻结肩的疗效评价  

Surgical outcomes of dual posterior assisted approach arthroscopic capsular release for treating frozen shoulder

作　　者：刘勇 唐金龙 汪松 朱正亚 李浩 蒋健 Liu Yong;Tang Jinlong;Wang Song;Zhu Zhengya;Li Hao;Jiang Jian(Department of Orthopedics,The Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu,221006,China)

机构地区：[1]徐州医科大学附属医院骨科,江苏徐州221006

出　　处：《生物骨科材料与临床研究》2025年第1期19-23,共5页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨肩关节镜的双后侧辅助入路松解治疗冻结肩的手术效果。方法回顾性分析2021年11月至2024年1月徐州医科大学附属医院收治的32例冻结肩患者资料。其中,男12例,女20例;NeviaserⅡ型23例,Ⅲ型9例。患者均进行肩关节镜下松解手术,采用双后侧辅助入路,松解范围包括肩袖间隙、盂肱中韧带、前下方关节囊、下方关节囊和后方关节囊组织,术后常规进行肩关节的前屈、外展、外旋和内旋康复锻炼。比较患者术前、术后6个月随访时的肩关节Constant评分、AESE评分、肩关节活动范围和VAS评分。结果所有患者获得随访,平均随访时间15个月(6个月~2年)。患者术后6个月复查VAS评分为(0.97±0.59)分,较术前[(6.28±0.99)分]明显降低,差异有统计学意义(P<0.05)。患者术后6个月Constant评分为(82.44±4.62)分,较术前[(41.66±7.36)分]明显改善,差异有统计学意义(P<0.05)。术前AESE评分(37.88±6.09)分,术后复查为(84.19±5.47)分,患者术后肩关节功能较术前明显改善,差异有统计学意义(P<0.05)。患者术前肩关节前屈、外展和外旋[(65.75±12.99)°、(70.34.±8.67)°、(10.19±4.43)°],术后改善为[(171.00±5.16)°、(170.5±4.40)°、(37.91±4.82)°],患者术后前屈、外展和外旋活动范围较术前明显改善,差异有统计学意义(P<0.05)。结论肩关节镜的双后侧辅助入路在松解治疗冻结肩患者,手术视野清晰,松解前下方关节囊完全,可明显改善肩关节的前屈、外展和外旋活动,减轻肩关节疼痛,是治疗重度冻结肩患者的一种有效方法。Objective To investigate the surgical outcomes of arthroscopic capsular release via a dual posterior assisted approach for the treatment of frozen shoulder.Methods A retrospective analysis was performed on patients with frozen shoulder treated at the Affiliated Hospital of Xuzhou Medical University between November 2021 and January 2024.The study included 12 male and 20 female patients,with 23 cases classified as Neviaser typeⅡand 9 cases classified as typeⅢ.Arthroscopic capsular release surgery was performed in our hospital using a double posterior assisted approach.The release range included the rotator interval,middle glenohumeral ligament,anterior-inferior joint capsule,inferior joint capsule,and posterior joint capsule.Postoperative rehabilitation exercises included shoulder flexion,abduction,external rotation,and internal rotation.The Constant score,ASES score,range of motion,and VAS score were compared between preoperative and six-month postoperative follow-up assessments.Results All patients were followed up for an average of 15 months(range:6 months to 2 years).The preoperative VAS score was(6.28±0.99)points,and the VAS score at the 6-month postoperative follow-up was(0.97±0.59)points,indicating significant pain relief and a statistically significant reduction in VAS score.The preoperative Constant score was(41.66±7.36)points,and it improved to(82.44±4.62)points at the 6-month postoperative follow-up,demonstrating a statistically significant improvement in shoulder function.The preoperative ASES score was(37.88±6.09)points,and it increased to(84.19±5.47)points at the postoperative follow-up,showing a statistically significant improvement in shoulder function.The range of motion for shoulder flexion,abduction,and external rotation improved from(65.75±12.99)°,(70.34±8.67)°,and(10.19±4.43)°preoperatively to(171.00±5.16)°,(170.5±4.40)°,and(37.91±4.82)°postoperatively,indicating statistically significant improvements in the range of motion.Conclusion Arthroscopic capsular release using a

关 键 词：冻结肩 双后侧辅助入路 关节囊松解 关节镜手术 

分 类 号：R686[医药卫生—骨科学]