CAJ | 학술논문

目的探讨关节镜下肩袖间隙滑移技术修补巨大回缩型肩袖损伤的疗效.方法 2007年1月至2010年12月采用关节镜下肩袖间隙滑移技术修补21例巨大回缩型肩袖损伤患者,男8例,女13例；年龄42 ～ 73岁,平均60.5岁；左侧7例,右侧14例.所有患者术后定期随访,末次随访时行X线及MRI检查.比较术前与末次随访时疼痛视觉模拟评分(VAS)、美国加利福尼亚大学洛杉矶分校(UCLA)评分及Constant-Murley评分,评价术后肩关节活动范围和功能恢复情况.结果所有患者术后获12～ 36个月(平均23.2个月)随访.术后无感染、伤口不愈合及肩关节感觉异常等并发症发生.末次随访时的X线片及MRI均显示肩关节在位良好,无明显肱骨头上移.术前VAS、UCLA及Constant-Murley评分平均分别为(4.6±1.3)、(8.7±2.5)、(38.1±7.7)分,末次随访时平均分别为(9.0±1.2)、(29.4±4.5)、(86.9±10.0)分,末次随访时较术前各项评分均有改善,差异均有统计学意义(P＜0.05).结论关节镜下肩袖间隙滑移技术修复巨大回缩型肩袖损伤在疼痛、活动范围、肌力及功能恢复方面均有明显改善,可获得较满意的临床效果.
목적 탐토관절경하견수간극활이기술수보거대회축형견수손상적료효.방법 2007년1월지2010년12월채용관절경하견수간극활이기술수보21례거대회축형견수손상환자,남8례,녀13례；년령42 ～ 73세,평균60.5세；좌측7례,우측14례.소유환자술후정기수방,말차수방시행X선급MRI검사.비교술전여말차수방시동통시각모의평분(VAS)、미국가리복니아대학락삼기분교(UCLA)평분급Constant-Murley평분,평개술후견관절활동범위화공능회복정황.결과 소유환자술후획12～ 36개월(평균23.2개월)수방.술후무감염、상구불유합급견관절감각이상등병발증발생.말차수방시적X선편급MRI균현시견관절재위량호,무명현굉골두상이.술전VAS、UCLA급Constant-Murley평분평균분별위(4.6±1.3)、(8.7±2.5)、(38.1±7.7)분,말차수방시평균분별위(9.0±1.2)、(29.4±4.5)、(86.9±10.0)분,말차수방시교술전각항평분균유개선,차이균유통계학의의(P＜0.05).결론 관절경하견수간극활이기술수복거대회축형견수손상재동통、활동범위、기력급공능회복방면균유명현개선,가획득교만의적림상효과.
Objective To evaluate the “slide“ technique used in arthroscopic repair of massive contracted rotator cuff tears.Methods Between January 2007 and December 2010,21 patients (8 men and 13 women) underwent arthroscopic repair of massive contracted rotator cuff tears using the ” slide” technique.Their mean age was 60.5 years,ranging from 42 to 73 years.Seven cases had the tear on the left side and 14 on the right.All patients were followed up until the last time by X-ray and MRI evaluations.The postoperative range of motion (ROM) and functional recovery were evaluated by comparing the preoperative visual analog scale (VAS) pain score,University of California at Los Angeles (UCLA) and Constant-Murley scores with those at the last follow-up.Results All patients were followed up for an average of 23.2 months (range,12 to 36 months).Good healing was achieved in all cases.The last follow-ups showed good alignment of the shoulder joint and no upper advancement of the humeral head.The average postoperative VAS,UCLA and Constant-Murley scores were respectively 4.6 ± 1.3,8.7 ± 2.5 and 38.1 ± 7.7,significantly better than those at the last follow-up (9.0 ± 1.2,29.4 ±4.5 and 86.9 ± 10.0 respectively) (P ＜0.05).No infection,nonunion or paresthesia of the shoulder joint was observed.Conclusion Arthroscopic repair of massive contracted rotator cuff tears using the ”slide” technique can lead to satisfactory clinical outcomes with respect to pain,ROM,muscle strength and functional recovery.