[目的]比较肱二头肌长头腱切断固定术和上盂唇锚钉缝合修复术治疗II型SLAP损伤的临床疗效。[方法]回顾性分析本院2018年1月—2021年6月收治的31例II型SLAP损伤患者的临床资料,根据医患沟通结果,16例采用肱二头肌长头腱切断固定术治疗(...[目的]比较肱二头肌长头腱切断固定术和上盂唇锚钉缝合修复术治疗II型SLAP损伤的临床疗效。[方法]回顾性分析本院2018年1月—2021年6月收治的31例II型SLAP损伤患者的临床资料,根据医患沟通结果,16例采用肱二头肌长头腱切断固定术治疗(腱固定组),15例采用带线锚钉缝合修复术(修复组),比较两组围手术期及随访结果。[结果]两组均顺利完成手术,两组手术时间、切口长度、术中失血量、主动活动时间、切口愈合和住院时间比较的差异均无统计学意义(P>0.05)。两组均获得至少1年的随访。两组完全负重活动时间的差异无统计学意义(P>0.05)。术后随时间推移,两组VAS、ASES、QuickDASH和Constant-Murley评分均显著改善(P<0.05)。术后3个月,腱固定组的VAS评分[(2.5±0.5) vs (3.7±1.0), P<0.001]显著优于修复组。末次随访,腱固定组的ASES [(93.7±1.8) vs (90.3±3.3), P=0.002]、QuickDASH [(8.9±1.9) vs (11.0±1.6), P=0.002]和Constant-Murley评分[(93.8±1.5) vs (91.1±3.1), P=0.006]均显著优于修复组,但两组VAS评分的差异已无统计学意义(P>0.05)。[结论]肱二头肌长头腱切断固定术和上盂唇的带线锚钉缝合修复术在治疗II型SLAP损伤上均有良好的效果,相比之下,肱二头肌长头腱切断固定术在患者术后半年的体验及疗效,较修复术更优。展开更多
One of the most common pathologic processes seen in overhead throwing athletes is posterior shoulderpain resulting from internal impingement. "Internal impingement" is a term used to describe a constellation...One of the most common pathologic processes seen in overhead throwing athletes is posterior shoulderpain resulting from internal impingement. "Internal impingement" is a term used to describe a constellation of symptoms which result from the greater tuberosity of the humerus and the articular surface of the rotator cuff abutting the posterosuperior glenoid when the shoulder is in an abducted and externally rotated position. The pathophysiology in symptomatic internal impingement is multifactorial,involving physiologic shoulder remodeling,posterior capsular contracture,and scapular dyskinesis. Throwers with internal impingement may complain of shoulder stiffness or the need for a prolonged warm-up,decline in performance,or posterior shoulder pain. On physical examination,patients will demonstrate limited internal rotation and posterior shoulder pain with a posterior impingement test. Common imaging findings include the classic "Bennett lesion" on radiographs,as well as articular-sided partial rotator cuff tears and concomitant SLAP lesions. Mainstays of treatment include intense non-operative management focusing on rest and stretching protocols focusing on the posterior capsule. Operative management is variable depending on the exact pathology,but largely consists of rotator cuff debridement. Outcomes of operative treatment have been mixed,therefore intense non-operative treatment should remain the focus of treatment.展开更多
文摘[目的]比较肱二头肌长头腱切断固定术和上盂唇锚钉缝合修复术治疗II型SLAP损伤的临床疗效。[方法]回顾性分析本院2018年1月—2021年6月收治的31例II型SLAP损伤患者的临床资料,根据医患沟通结果,16例采用肱二头肌长头腱切断固定术治疗(腱固定组),15例采用带线锚钉缝合修复术(修复组),比较两组围手术期及随访结果。[结果]两组均顺利完成手术,两组手术时间、切口长度、术中失血量、主动活动时间、切口愈合和住院时间比较的差异均无统计学意义(P>0.05)。两组均获得至少1年的随访。两组完全负重活动时间的差异无统计学意义(P>0.05)。术后随时间推移,两组VAS、ASES、QuickDASH和Constant-Murley评分均显著改善(P<0.05)。术后3个月,腱固定组的VAS评分[(2.5±0.5) vs (3.7±1.0), P<0.001]显著优于修复组。末次随访,腱固定组的ASES [(93.7±1.8) vs (90.3±3.3), P=0.002]、QuickDASH [(8.9±1.9) vs (11.0±1.6), P=0.002]和Constant-Murley评分[(93.8±1.5) vs (91.1±3.1), P=0.006]均显著优于修复组,但两组VAS评分的差异已无统计学意义(P>0.05)。[结论]肱二头肌长头腱切断固定术和上盂唇的带线锚钉缝合修复术在治疗II型SLAP损伤上均有良好的效果,相比之下,肱二头肌长头腱切断固定术在患者术后半年的体验及疗效,较修复术更优。
文摘One of the most common pathologic processes seen in overhead throwing athletes is posterior shoulderpain resulting from internal impingement. "Internal impingement" is a term used to describe a constellation of symptoms which result from the greater tuberosity of the humerus and the articular surface of the rotator cuff abutting the posterosuperior glenoid when the shoulder is in an abducted and externally rotated position. The pathophysiology in symptomatic internal impingement is multifactorial,involving physiologic shoulder remodeling,posterior capsular contracture,and scapular dyskinesis. Throwers with internal impingement may complain of shoulder stiffness or the need for a prolonged warm-up,decline in performance,or posterior shoulder pain. On physical examination,patients will demonstrate limited internal rotation and posterior shoulder pain with a posterior impingement test. Common imaging findings include the classic "Bennett lesion" on radiographs,as well as articular-sided partial rotator cuff tears and concomitant SLAP lesions. Mainstays of treatment include intense non-operative management focusing on rest and stretching protocols focusing on the posterior capsule. Operative management is variable depending on the exact pathology,but largely consists of rotator cuff debridement. Outcomes of operative treatment have been mixed,therefore intense non-operative treatment should remain the focus of treatment.
