摘要
目的探讨关节镜下松解术治疗冻结肩的疗效.方法2001年10月～2003年10月,我院对25例冻结肩在关节镜下行松解术.全麻下肩关节后路进镜,前路进射频电刀烧灼肱二头肌长头肌腱及肩袖间隙部位的滑膜充血炎症区,切割盂肱上韧带、盂肱中韧带、肩胛下肌肌腱关节囊内部分,手法松解剩余挛缩.25例术后3、6个月随访肩关节活动范围及美国肩肘协会评分(ASES).结果手术时间75～98 min,平均85 min.无术中并发症.25例除术后1周肩关节内旋与术前无明显改善外(x2=8.558,P=0.073),术后各个时期肩关节其它活动范围比术前均有明显改善(P＜0.05).术后3个月和6个月比术后1周改善更明显(P＜0.05).25例术后3个月和6个月ASES评分(87.4±4.6,88.1±6.0)均比术前(45.8±10.0)明显改善(q=28.738,29.221;P＜0.05),但3个月与6个月评分相比较无显著性差异(q=0.484,P＞0.05).结论肩关节镜下手术松解冻结肩可以明显缩短病程,取得稳定满意的效果.
Objective To evaluate the efficacy of arthroscopic capsular release of trozen shoulder. Methods Twenty -live patients with frozen shoulder were treated arthroscopically from October 2001 to October 2003 in this hospital. The operation was performed under general anesthesia. The arthoscope was inserted through a posterior approach and the radiofrequency electrotome was inserted via an anterior approach. The synovitis of the biceps tendon and the rotator interval was thermo - coagulated. The superior glenohumeral ligament, the middle glenohumeral ligament, and the intra - capsular part of subseapularis tendon were cut to release the capsule. The combination manipulation was performed to release the residual contracture. The range of motion of the shoulder and the American Shoulder ＆ Elbow Surgeons （ASES） scores were recorded at 3 and 6 postoperative months, respectively. Results The operative time was 75 -95 min（ mean,85 min）. No intraoperative complications were found. As compared with preoperative conditions, the motion of inward rotation revealed no significant improvement at 1 week after operation （χ^2 = 8. 558, P = 0. 073） and other shoulder motions were significantly improved at different postoperative stages （P 〈 0.05 ）. The range of motion of the shoulder greatly improved at 3 and 6 postoperative months than at 1 postoperative week （P 〈 0.05 ）. The ASES scores significantly increased 3 and 6 months postoperatively （ 87.4 ± 4.6 and 88.1 ± 6.0） than preoperatively （45.8 ± 10.0） （ q = 28. 738, P 〈 0.05 ; q = 29.221, P 〈 0.05 ）. There was no significant difference in the ASES scores between 3 and 6 postoperative months （ q = 0. 484, P 〉 0.05 ）. Conclusions Arthroscopic release for the treatment of frozen shoulder may obviously shorten the period of the disease and obtain good curative effects.
出处
《中国微创外科杂志》
CSCD
2005年第12期1023-1024,共2页
Chinese Journal of Minimally Invasive Surgery
基金
首都医学发展科研基金资助(编号:2002-3053)
关键词
冻结肩
关节镜
松解术
Frozen shoulder
Arthroscope
Release
