关节镜下改良压配式双排缝合技术治疗肩袖大型撕裂早期疗效分析

发布时间：2018-10-04 19:45

【摘要】：目的评价关节镜下改良压配式(Improved-press-fit)双排缝合(DR)技术治疗肩袖大型撕裂的早期临床疗效。方法回顾分析2013年12月-2014年11月,采用关节镜下Improved-press-fit DR技术治疗52例大型肩袖全层撕裂患者。其中,男20例,女32例,平均年龄65.6岁(51~76岁),术后肩外展6周固定,允许早期被动活动度训练,在治疗前后分别采用疼痛视觉模拟评分(VAS)、肩关节前屈和体侧外旋角度(ROM)、美国加州大学洛杉矶分校肩关节评分(UCLA)及美国肩肘外科评分标准(ASES)进行疗效评价,观察术后6个月时功能恢复情况,并与术前相应指标进行比较。结果术后平均随访10.9个月(6~17个月),患者术后6个月时VAS疼痛评分(1.6±0.9)分,前屈上举(145.6±10.7)°,体侧外旋(30.8±8.5)°,UCLA评分(32.3±3.5)分,ASES评分(81.8±8.7)分,较术前均明显好转,所有评价指标差异有统计学意义(P0.05),随访期间无肩袖再撕裂发生。结论关节镜下Improved-press-fit DR技术治疗大型肩袖全层撕裂安全有效,与缝合桥技术相比可减少置钉数,缩短手术时间,操作简便,是一种简单、经济的缝合方法。
[Abstract]:Objective to evaluate the early clinical effect of arthroscopic modified compression matching (Improved-press-fit) double-row suture (DR) technique in the treatment of large rotator cuff tears. Methods from December 2013 to November 2014, 52 patients with large rotator cuff tears were treated with arthroscopic Improved-press-fit DR. There were 20 males and 32 females, with an average age of 65.6 years (51 / 76 years). The shoulder abduction was fixed for 6 weeks after operation, allowing early passive activity training. Pain visual analogue score (VAS),) and lateral rotation angle (ROM),) and shoulder joint score (UCLA) of UCLA were used to evaluate the efficacy before and after treatment. The functional recovery at 6 months after operation was observed and compared with the corresponding indexes before operation. Results the average follow-up time was 10.9 months (6-17 months). The scores of VAS pain, anterior flexion and lateral rotation were (145.6 卤10.7) 掳, (32.3 卤3.5) 掳and (81.8 卤8.7), respectively. The difference of all evaluation indexes was statistically significant (P0.05), and no rotator cuff tear occurred during follow-up. Conclusion arthroscopic Improved-press-fit DR technique is safe and effective in the treatment of large rotator cuff full-layer tear. Compared with the suture bridge technique, it can reduce the number of nail insertion, shorten the operation time, and is a simple and economical suture method.
【作者单位】：浙江省嘉兴市第二医院骨科;
【分类号】：R687.4

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