| 肩袖缝合同期关节镜下360°松解治疗肩袖损伤合并全方位肩关节粘连 |
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Received:January 20, 2020
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| 作者 | Author | 单位 | Unit | E-Mail |
| 马佳 |
MA Jia |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Science, Beijing 100102, China |
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| 张磊 |
ZHANG Lei |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Science, Beijing 100102, China |
f3c_ma@163.com |
| 朱立国 |
ZHU Li-guo |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Science, Beijing 100102, China |
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| 孙晋 |
SUN Jin |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Science, Beijing 100102, China |
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| 张晟 |
ZHANG Sheng |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Science, Beijing 100102, China |
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| 刘晓华 |
LIU Xiao-hua |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Science, Beijing 100102, China |
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| 姜博 |
JIANG Bo |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Science, Beijing 100102, China |
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| 李妍 |
LI Yan |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Science, Beijing 100102, China |
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| 期刊信息：《中国骨伤》2020年33卷，第4期，第348-352页 |
| DOI：10.12200/j.issn.1003-0034.2020.04.011 |
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目的：评估肩袖损伤合并全方位肩关节粘连患者，进行肩袖缝合同期关节镜下360°关节囊松解手术的临床疗效。
方法：2016年12月至2018年12月共收治247例肩袖全层撕裂的患者，采用关节镜下肩袖缝合手术治疗。其中全方位肩关节活动受限的患者42例（17%），在肩袖缝合的同时，采取关节镜下360°关节囊松解手术。分别在术前及末次随访时采用Constant-Murley评分，疼痛视觉模拟评分（visual analogue score，VAS），前屈、外展及体侧外旋角度进行肩关节功能评估。采用核磁影像Sugaya分类对肩袖愈合情况进行评估。记录随访过程中肩脱位发生的次数。
结果：42例中39例获得随访，随访时间12~36（22±6）个月。患者手术时年龄43~73（57±7）岁，Constant-Murley评分自术前的（43.6±6.3）分提升至末次随访的（87.5±2.8）分（P<0.001）。VAS评分自术前的（7.2±1.5）分降低至末次随访的（1.0±0.9）分（P<0.001）。肩关节前屈自术前的（46±14）°提高至术后的（148±11）°（P<0.001），外展自术前的（36±6）°提高至术后的（121±10）°（P<0.001），体侧外旋自术前的（5±10）°提高至术后的（42±8）°（P<0.001）。术后1年复查MRI，Sugaya分类标准中Ⅰ-Ⅲ类为临床愈合，共38例。
结论：采用肩袖缝合同期关节镜下360°关节囊松解，治疗肩袖损伤合并全方位肩关节粘连，主要观察指标在术后改善，临床疗效确切。 |
| [关键词]:回旋套损伤 关节镜 肩关节 关节囊松解 |
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| Treatment of rotator cuff tear in global stiff shoulder by arthroscopic 360° capsular release with concomitant rotator cuff repair |
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Abstract:
Objective: To evaluate the clinical effect of arthroscopic 360° capsular release with concomitant rotator cuff repair for patients with rotator cuff tears in global stiff shoulder.
Methods: From December 2016 to December 2018,247 patients full-thickness rotator cuff tear were treated with arthroscopic rotator cuff repair. Among them,42 patients(17%) with global limitation of shoulder movement were treated with arthroscopic 360° capsular release operation at the same time of rotator cuff repair. The function of shoulder was evaluated by Constant-Murley score and visual analogue scales (VAS),flexion,abduction and external rotation on body side before and after operation. Sugaya classification was used to evaluate the healing of rotator cuff. The number of shoulder dislocations during follow-up was recorded.
Results: Thirty-nine of the 42 patients were followed up for 12 to 36(22±6) months. The patients were 43 to 73(57±7) years old at the time of operation. The Constant-Murley score increased from (43.6±6.3) before operation to (87.5±2.8) at final follow-up(P<0.001). VAS score decreased from (7.2±1.5) before operation to (1.0±0.9) at final follow-up (P<0.001). The flexion of shoulder increased from (46±14)° before operation to (148±11)° after operation (P<0.001),the abduction from (36±6)° before operation to (121±10)° after operation (P<0.001),and the external rotation on body side from (5±10)° before operation to (42±8)° after operation(P<0.001). One year after the operation,MRI showed thatⅠ-Ⅲ of Sugaya classification was clinical healing,38 cases in total.
Conclusion: Arthroscopic 360° capsular release with concomitant rotator cuff repair was used to treat rotator cuff tear in global stiff shoulder. The main observation indexes were improved after operation,and the clinical effect was definite. |
| KEYWORDS:Rotator cuff injuries Arthroscopes Shoulder joint Joint capsule release |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 马佳,张磊,朱立国,孙晋,张晟,刘晓华,姜博,李妍.肩袖缝合同期关节镜下360°松解治疗肩袖损伤合并全方位肩关节粘连[J].中国骨伤,2020,33(4):348~352 |
| 英文格式: | MA Jia,ZHANG Lei,ZHU Li-guo,SUN Jin,ZHANG Sheng,LIU Xiao-hua,JIANG Bo,LI Yan.Treatment of rotator cuff tear in global stiff shoulder by arthroscopic 360° capsular release with concomitant rotator cuff repair[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(4):348~352 |
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