[1]李宁,秦立武,王佩,等.关节镜下单排改良Mason-Allen缝合技术修复老年中型肩袖撕裂[J].中医正骨,2020,32(11):52-54.
点击复制

关节镜下单排改良Mason-Allen缝合技术修复老年中型肩袖撕裂()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年11期
页码:
52-54
栏目:
临床报道
出版日期:
2020-11-20

文章信息/Info

作者:
李宁; 秦立武; 王佩; 王友强
(山东省文登整骨医院,山东 威海 264400)
关键词:
肩关节;  肩袖撕裂;  关节镜检查;  缝合技术;  缝合锚;  老年人
摘要:
目的:观察关节镜下单排改良Mason-Allen缝合技术修复老年中型肩袖撕裂的临床疗效和安全性。方法:2017年3月至2018年10月,采用关节镜下单排改良Mason-Allen缝合技术修复老年中型肩袖撕裂患者16例,男9例、女7例; 年龄60～71岁,中位数64岁; 左肩6例,右肩10例; 外伤性损伤3例,退行性损伤13例; 按照Cofield肩袖撕裂分类法,均为中型肩袖撕裂(1～3 cm)。病程1～6个月,中位数3个月。随访观察腱-骨愈合、肩部疼痛改善、肩关节功能恢复及并发症发生情况。结果:所有患者均获随访,随访时间10～14个月,中位数12个月。末次随访时,所有患者MRI显示腱-骨愈合良好。肩部疼痛视觉模拟量表评分,术前(5.88±1.31)分、末次随访时(1.06±0.68)分; 美国肩肘外科评分,术前(31.81±6.18)分、末次随访时(80.81±17.57)分; 加州大学洛杉矶分校肩关节评分,术前(10.63±3.26)分、末次随访时(31.50±5.96)分。2例患者因术后康复锻炼不规范出现冻结肩症状,经规范的康复锻炼后症状消失。所有患者均未出现肩袖再撕裂、锚钉退出等并发症。结论:采用关节镜下单排改良Mason-Allen缝合技术修复老年中型肩袖撕裂,腱-骨愈合率高,可有效缓解肩关节疼痛、改善肩关节功能,且并发症少。

参考文献/References:

[1] MOOSMAYER S,SMITH H J,TARIQ R,et al.Prevalence and characteristics of asymptomatic tears of the rotator cuff:an ultrasonographic and clinical study[J]. J Bone Joint Surg Br,2009,91(2):196-200.
[2] COLE B J,COTTER E J,WANG K C,et al.Patient understanding,expectations,and satisfaction regarding rotator cuff injuries and surgical management[J].Arthroscopy,2017,33(8):1603-1606.
[3] BOYER P,BOUTHORS C,DELCOURT T,et a1.Arthroscopic double-row cuff repair with suture-bridging:a structural and functional comparison of two techniques [J].Knee Surg Sports Traumatol Arthrosc,2015,23(2):478-486.
[4] WOODMASS J M,WAGNER E R,CHANG M J,et al.Arthroscopic treatment of massive posterosuperior rotator cuff tears:a critical analysis review[J].JBJS Rev,2018,6(9):e3.
[5] CADET E R,HSU J W,LEVINE W N,et al.The relationship between greater tuberosity steopenia and the chronicity of rotator cuff tears[J].J Shoulder Elbow Surg,2008,17(1):73-77.
[6] AZAR F M,BEATY J H,CANALE S T.坎贝尔骨科手术学[M].唐佩福,王岩,卢世璧,译.13版.北京:北京大学医学出版社,2018:2177.
[7] 陈建海.巨大肩袖撕裂:病理机制、治疗方法和临床结果[J].中华肩肘外科电子杂志,2015,3(4):238-243.
[8] 彭兆祥,李瑾,林杰,等.全身应用抗生素治疗关节镜下肩袖撕裂修复术后感染[J].中医正骨,2019,31(2):52-55.
[9] SCHEIBEL M T,HABERMEYER P.A modified Mason-Allen technique for rotator cuff repair using suture anchors[J].Arthroscopy,2003,19(3):330-333.
[10] RICHARDS R R,AN K N,BIGLIANI L U,et al.A standardized method for the assessment of shoulder function[J].J Shoulder Elbow Surg,1994,3(6):347-352.
[11] AMSTUTZ H C,SEW HOY A L,CLARKE I C.UCLA anatomic total shoulder arthroplasty[J].Clin Orthop Relat Res,1981(155):7-20.
[12] GERBER C,SCHNEEBERGER A G,BECK M,et a1.Mechanical strength of repairs of the rotator cuff[J].J Bone Joint Surg Br,1994,76(3):371-380.
[13] JUNG S W,KIM D H,KANG S H,et al.Arthroscopic modified Mason-Allen technique for large U- or L-shaped rotator cuff tears[J].Knee Surg Sports Traumatol Arthrosc,2017,25(7):2129-2137.
[14] LEE K W,YANG D S,LEE G S,et al.Clinical outcomes and repair integrity after arthroscopic full-thickness rotator cuff repair:suture-bridge versus double-row modified Mason-Allen technique[J].J Shoulder Elbow Surg,2018,27(11):1953-1959.
[15] CADET E R,HSU J W,LEVINE W N,et al.The relationship between greater tuberosity osteopenia and the chronicity of rotator cuff tears[J].J Shoulder Elbow Surg,2008,17(1):73-77.
[16] 沈继,何耀华,耿德春,等.关节镜治疗老年巨大肩袖撕裂的疗效分析[J].中华医学杂志,2017,97(15):1145-1149.
[17] BENNETT W F.Arthroscopic repair of massive rotator cuff tears:a prospective cohort with 2- to 4-year follow-up[J].Arthroscopy,2003,19(4):380-390.
[18] 熊晓扬,钱平康,高峰,等.维生素D在肩袖损伤修复中的作用研究进展[J].中医正骨,2019,31(1):33-35.
[19] 潘孝云,陈成旺,温宏,等.关节镜下双排缝合桥固定技术治疗冈上肌肌腱破裂[J].中医正骨,2014,26(2):32-33.
[20] 龚继承,张洪鑫,唐康来.关节镜下改良缝合桥技术与单排改良Mason-Allen缝合修复冈上肌腱损伤的疗效比较[J].中华创伤杂志,2017,33(8):691-697.
[21] MILLETT P J,WARTH R J,DORNAN G J,et al.Clinical and structural outcomes after arthroscopic single-row versus double-row rotator cuff repair:a systematic review and meta-analysis of level I randomized clinical trials[J].J Shoulder Elbow Surg,2014,23(4):586-597.
[22] PLACHEL F,SIEGERT P,RüTTERSHOFF K,et al.Long-term results of arthroscopic rotator cuff repair:a follow-up study comparing single-row versus double-row fixation techniques[J].Am J Sports Med,2020,48(7):1568-1574.

相似文献/References:

[1]王亮,王予彬,汤华林.肩袖损伤和创伤性肩关节前方不稳定患者肩部疼痛 与肩峰下滑囊组织中炎症反应的关系研究[J].中医正骨,2015,27(10):5.
　WANG Liang,WANG Yubin,TANG Hualin.Study on the relationship between shoulder pain and inflammatory reaction in the subacromial bursa tissues in patients with rotator cuff injury and traumatic shoulder joint anterior instability[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(11):5.
[2]张昕煜,曹旭,李少雷,等.推拿手法联合康复训练治疗慢性肩袖损伤[J].中医正骨,2017,29(01):52.
[3]李霞,迟涛胜,徐美丽,等.肩关节镜手术治疗肩袖损伤的围手术期护理[J].中医正骨,2017,29(09):77.
[4]王守立,周晓波,刘福存,等.国人肩峰指数与肩袖撕裂的关系研究…[J].中医正骨,2017,29(12):31.
　WANG Shouli,ZHOU Xiaobo,LIU Fucun,et al.Study on the relationship between acromion index and rotator cuff tear in Chinese[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(11):31.
[5]娄路馨,程晓光,于爱红.MRI在儿童三角肌挛缩诊断中的应用价值[J].中医正骨,2018,30(01):41.
[6]应亚草,彭兆祥,李瑾,等.1129例肩袖损伤患者的冈上肌出口位X线片分析[J].中医正骨,2018,30(03):39.
[7]陈罗西,沈海.传统关节黏连松解术配合运动疗法治疗创伤性肩关节僵硬[J].中医正骨,2018,30(12):52.
[8]熊晓扬,钱平康,高峰,等.维生素D在肩袖损伤修复中的作用研究进展[J].中医正骨,2019,31(01):33.
[9]李文杰,包招兰,江显俊,等.体外冲击波联合腕踝针治疗肱二头肌长头肌腱炎的临床研究[J].中医正骨,2019,31(02):5.
　LI Wenjie,BAO Zhaolan,JIANG Xianjun,et al.A clinical study of extracorporeal shockwave therapy combined with wrist-ankle acupuncture therapy for treatment of myotenositis of long head of biceps brachii[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(11):5.
[10]田子睿,姚敏,王拥军,等.中文版Constant-Murley肩关节评分量表的研制与应用[J].中医正骨,2019,31(05):20.
[11]彭兆祥,李瑾,林杰,等.全身应用抗生素治疗关节镜下肩袖撕裂修复术后感染[J].中医正骨,2019,31(02):52.

备注/Memo

备注/Memo:
通讯作者:秦立武 E-mail:wuliqin65@163.com
更新日期/Last Update: 2020-11-20