摘要
目的:比较关节镜缝合桥技术与单排技术治疗肩袖撕裂的疗效。方法:回顾性分析采用关节镜缝合桥技术与单排技术治疗肩袖撕裂患者的资料,其中缝合桥固定组22例,单排组21例,采用疼痛目测评分(PVAS)、肩关节活动度、美国肩肘外科评分(ASES)、加州大学肩关节评分(UCLA)、复旦大学肩关节评分(FUSS评分)及Constant评分比较两组术前、术后第3 d、术后6月情况,并对术后6月撕裂肩袖的完整性及再撕裂率进行评估。结果:43例均获得随访,缝合桥固定组术后第3 d、术后6月PVAS评分分别为(2.41±1.05)分、(1.12±0.21)分,ASES评分分别为(13.29±1.57)分、(17.33±2.34)分,UCLA评分分别为(23.67±3.07)分、(33.61±3.64)分,Constant评分分别为(76.24±7.36)分、(87.96±8.49)分,FUSS评分分别为(75.43±12.06)分、(88.46±13.07)分,肩关节活动度前屈(160.28±11.57)?、外展(159.38±17.26)?、体侧外旋(48.08±1.81)?,这两时间点各指标值与术前比较,差异均有统计学意义(P<0.05);单排组术后第3 d、术后6月PVAS评分分别为(3.52±1.31)分、(2.07±0.35)分,ASES评分分别为(10.25±1.18)分、(15.28±2.17)分,UCLA评分分别为(17.35±3.44)分、(28.57±3.52)分,Constant评分分别为(68.33±7.18)分、(78.69±8.05)分,FUSS评分分别为(68.25±11.36)分、(78.93±12.58)分,肩关节活动度前屈(154.63±12.08)?、外展(148.16±18.57)?、体侧外旋(43.18±10.06)?,这两时间点各指标值与术前比较,差异也有统计学意义(P<0.05);缝合桥固定组术后第3 d和术后6月各指标值均高于单排组(P<0.05);术后6月,缝合桥固定组2例(9.09%)、单排组3例(14.29%)发生肩袖再撕裂(P=1.000)。结论:关节镜缝合桥技术与单排技术均能治疗肩袖撕裂,前者在肩关节功能活动方面更具有优势,且安全性高,但在复发率方面无明显差异。
Objective To compare the clinical curative effect of suture bridge technique combined with single row technique under arthroscope in the treatment of rotator cuff tear.Methods A retrospective analysis was performed on43patients with rotator cuff tear treated by suture bridge technique combined with single row technique under arthroscope.There were22cases in suture bridge fixed group and21cases in single row group,then patients were compared between the two groups after surgery,3d after surgery and6months after surgery,the integrity of rotator cuff and retear rate were assessed6months after surgery using pain visual analogue scale(PVAS),shoulder joint activity,American shoulder and elbow surgeons score(ASES),score of University of California at Los Angeles(UCLA),Fudan University shoulder score(FUSS)and Constant score.Results All43patients were followed up,the PVAS scores in suture bridge fixed group of3d and6months were(23.67±3.07)and(33.61±3.64),ASES scores were(13.29±1.57)and(17.33±2.34),UCLA scores were(23.67±3.07)and(33.61±3.64),Constant scores were(76.24±7.36)and(87.96±8.49),FUSS scores were(75.43±12.06)and(88.46±13.07),with shoulder joint flexion of(160.28±11.57)°,abduction(159.38±17.26)°and lateral rotation(48.08±1.81)°,the difference between the two time points and preoperative values was statistically significant(P<0.05).The PVAS scores in single row technique group of3d and6months were(3.52±1.31)and(2.07±0.35),ASES scores were(10.25±1.18)and(15.28±2.17),UCLA scores were(17.35±3.44)and(28.57±3.52),Constant scores were(68.33±7.18)and(78.69±8.05),FUSS scores were(68.25±11.36)and(78.93±12.58),with shoulder joint flexion of(154.63±12.08)°,abduction(148.16±18.57)°and lateral rotation(43.18±10.06)°.The difference between the two time points and preoperative values was statistically significant(P<0.05);and shoulder motion of3d after surgery and6months after surgery had statistically significant differences compared with that before surgery(P<0.05).In6months after the operation,2cases(9.09%)in the suture bridge fixed group and3cases(14.29%)in the single row group were found to have the resection of the shoulder cuff(P=1.000).Conclusion The suture bridge technique and single row technique under arthroscope both can be used to treat rotator cuff tear,but the former has an advantage in shoulder joint function,and has high safety,but there is no significant difference in the recurrence rate.
作者
史永涛
白东昱
宗龙泽
SHI Yong-tao;BAI Dong-yu;ZONG Long-ze(Department of Joint Surgery, Affiliated Hospital ofYan' an University, Yan' an (716000), China)
出处
《中国中西医结合外科杂志》
CAS
2018年第6期691-696,共6页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
陕西省社会发展科技攻关项目(2016SF-187)
关键词
肩袖撕裂
关节镜
缝合桥技术
单排技术
Rotator cuff tear
arthroscope
suture bridge technique
single row technique
