文章摘要
张亮,赵赞栋,康鑫,任博,张宪,郑江.关节镜下缝线桥技术治疗老年肩关节脱位合并冈上肌止点撕脱骨折.骨科,2020,11(6):475-479
关节镜下缝线桥技术治疗老年肩关节脱位合并冈上肌止点撕脱骨折
Arthroscopic suture bridge technique for elderly patients with shoulder dislocation combined with supraspinatus avulsion fracture
投稿时间:2020-07-30  
DOI:10.3969/j.issn.1674-8573.2020.06.003
中文关键词: 肩关节脱位  肩袖撕裂  关节镜缝线桥  老年
英文关键词: Dislocation of shoulder  Rotator cuff tear  Arthroscopic suture bridge  Old age
基金项目:
作者单位E-mail
张亮 西安交通大学医学院附属红会医院运动医学中心西安 710054  
赵赞栋 西安交通大学医学院附属红会医院运动医学中心西安 710054  
康鑫 西安交通大学医学院附属红会医院运动医学中心西安 710054  
任博 西安交通大学医学院附属红会医院运动医学中心西安 710054  
张宪 西安交通大学医学院附属红会医院运动医学中心西安 710054  
郑江 西安交通大学医学院附属红会医院运动医学中心西安 710054 zhengjiang1010@126.com 
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中文摘要:
      目的 探讨关节镜下缝线桥技术治疗老年肩关节脱位合并冈上肌止点撕脱骨折的临床疗效。方法 回顾性分析21例肩关节脱位合并冈上肌止点撕脱骨折老年病人的病例资料,其中男13例,女8例,年龄为(53.7±2.3)岁,受伤至手术时间为(2.8±1.3) d,均采用关节镜下缝线桥技术固定治疗冈上肌止点撕脱骨折。采用改良Constant-Murley评分、上肢功能障碍评分量表(Disability of Arm, Shoulder and Hand, DASH)评分、Rowe评分评价肩关节功能;采用测角仪评估病人术后的运动范围(前倾、外展、外旋)。术后复查X线评估骨折愈合情况。结果 本组21例随访(23.4±7.1)个月,未见骨折不愈合及肩袖再撕裂病人,2例(9.5%)由于肩关节僵硬进行了松解,1例有一次创伤性再脱位(4.8%)。患侧Constant-Murley评分为84.3%±11.2%,DASH评分为(12.7±7.3)分,Rowe评分为(81.8±9.2)分,与健侧相比,评分差异均无统计学意义(P均>0.05)。运动范围方面,患侧和健侧在前屈、外展和内旋时的角度比较,差异均无统计学意义(P均>0.05),但两者主动外旋时的角度比较,差异有统计学意义(t=-8.904,P=0.018)。结论 关节镜下缝线桥技术治疗老年肩关节脱位合并冈上肌止点撕脱骨折可获得良好的功能效果,复发脱位率低。
英文摘要:
      Objective To explore the efficacy of arthroscopic suture bridge technology in the treatment of dislocation of the old shoulder joint and supraspinatus avulsion fracture. Methods Twenty-one cases of shoulder dislocation combined with supraspinatus avulsion fracture of elderly patients were retrospectively analyzed. There were 13 males and 8 females aged (53.7±2.3) years old. The time from injury to operation was (2.8±1.3) d. All of them were treated with arthroscopic suture bridge technique to fix the avulsion of supraspinatus. The improved Constant-Murley score, upper limb dysfunction scale (Disability of Arm, Shoulder and Hand, DASH), and Rowe score were used to evaluate the function of shoulder. An angle measuring instrument was used to evaluate the range of motion (forward flexion, abduction, external rotation). X-ray plain films were reviewed after surgery to assess fracture healing. Results Twenty-one patients were followed up for (23.4±7.1) months without fracture nonunion and rotator cuff re-tear. Two patients (9.5%) were relieved due to shoulder stiffness and 1 patient had a traumatic re-dislocation (4.8%). Constant-Murley score was 84.3%±11.2%, DASH score was rated 12.7±7.3 and Rowe scored 81.8±9.2, and there was no significant difference between the affected side and the healthy side (P>0.05 for all). There was no significant difference in the angle between the affected side and the healthy side during forward flexion, abduction and internal rotation (P>0.05 for all), but the difference was statistically significant in the angle during active external rotation (t=-8.904, P=0.018). Conclusion Arthroscopic suture bridge technique for the treatment of supraspinatus avulsion fracture with shoulder dislocation in the elderly could result in active limb function and lower recurrence rate of dislocation.
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