| 引用本文： |
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李 军,陈忆超,葛恒安,等.关节镜下修复肩胛下肌腱撕裂的手术技巧及早期临床疗效观察[J].同济大学学报（医学版）,2018,39(5):94-98,104. [点击复制]
- LI Jun,CHEN Yi-chao,GE Heng-an,et al.Arthroscopic subscapularis repair: surgical techniques and short-term clinical outcomes[J].同济大学学报（医学版）,2018,39(5):94-98,104. [点击复制]
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| 摘要: |
| 目的 探究肩关节镜下修复肩胛下肌腱撕裂的手术难点、手术技巧并观察早期临床疗效。方法 2015年6月—2016年6月，应用肩关节镜手术治疗32例肩胛下肌腱撕裂患者分别于术前、术后1个月、术后1年对患者进行Bear Hug test、Belly press test、UCLA评分、Constant评分检查肩关节功能恢复状况，AFE、AER、AIR评估患肩活动度，MacNab优良率评估患者对恢复状况的满意度，并采集患者各个时间点的影像学资料进行评估分析。结果 所有患者均顺利完成手术，随访时间平均为16.53个月，术后1个月和术后1年分别与术前相比，各评价指标均存在显著差异（均P<0.01）；术后1个月和术后1年的比较分析，除AFE（P=0.103）外，其余指标均存在统计学差异（均P<0.01）。Bear Hug test(+)、Belly press test(+)患者例数在术后呈现显著性下降，MacNab优良率在术后1个月为81.25%，术后1年提升至90.63%。术后1年MRI显示肌腱基本愈合。结论 肩关节镜下修复肩胛下肌腱撕裂治疗效果肯定，与传统开放手术相比，肩关节镜手术具有创伤更小、术中视野更清晰、术后疼痛更小、恢复更快等优势，但其手术操作难度高、风险大，需要术者拥有一定的手术经验及技巧。 |
| 关键词: 肩胛下肌 撕裂 关节镜 治疗 疗效 |
| DOI：10.16118/j.1008-0392.2018.05.018 |
| 投稿时间：2018-03-11 |
| 基金项目:国家自然科学基金项目面上项目（81372005、81401851）；上海市科委项目（13DZ194808、15441904403） |
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| Arthroscopic subscapularis repair: surgical techniques and short-term clinical outcomes |
| LI Jun,CHEN Yi-chao,GE Heng-an,CHENG Biao |
| (Dept. of Orthopedics, Tenth People’s Hospital, Tongji University, Shanghai 200072, China) |
| Abstract: |
| Objective To discuss the difficulties and surgical skills of arthroscopic subscapularis repair and to evaluate the short-term clinical outcomes. Methods From June 2015 to June 2016, 32 patients with subscapularis tear were treated under arthroscopic surgery. The shoulder function was evaluated with Bear Hug test, Belly press test, UCLA and Constant; the shoulder motion was evaluated with AFE, AER, AIR before operation and 1 months, 1 year after operation. The patients satisfaction for recovery was assessed with MacNab; meanwhile, the MRI findings were also assessed at all time points. Results All surgical procedures were successful, the mean follow-up period was 16.53 months. There was significant differences in evaluation scores before and 1 month or 1 year after surgery(P<0.01), and also between those at 1 month and 1 year after surgery(P<0.01), except for AFE(P=0.103). Patients with Bear Hug test(+) and Belly press(+) were significantly improved after surgery. The MacNab excellent and good rate was 81.25% at one month after surgery, 90.63% at one year after surgery. MRI showed complete healing of the torn subscapularis in all cases at 1 year after surgery. Conclusion Arthroscopic subscapularis repair is effective and safe; compared with the traditional open surgery, arthroscopic subscapularis repair surgery has advantages of less trauma, clearer intraoperative vision, less postoperative pain and faster recovery. However, it is relatively difficult to learn initially, and certain operation experience and skills are needed. |
| Key words: subscapularis tear arthroscopy treatment outcome |
