目的 对比单排张力带技术和缝合桥技术修复肩袖滑囊面部分撕裂的疗效。方法 回顾性分析2017-03至2018-03武警江西总队医院骨科经关节镜穿肌腱原位修复的高级别肩袖滑囊面部分撕裂患者46例的临床资料。其中,25例采用单排张力带技术修复(张力带组),21例采用缝合桥技术修复(缝合桥组)。对比两组手术时间、肩关节疼痛视觉模拟(VAS)评分、肩关节Constant评分及美国肩肘外科协会(ASES)评分、按照Sugaya放射学分型标准评估肩袖再撕裂情况。结果 46例均顺利完成手术,术中均未出现重要血管、神经损伤,术后均获得24~36个月的随访。张力带组手术时间为(55.52±8.21) min,明显短于缝合桥组的(69.10±8.85) min,差异有统计学意义(P<0.05)。末次随访时,张力带组及缝合桥组患者的肩关节疼痛VAS评分、肩关节Constant评分、ASES评分,与术前比较均明显改善,差异均有统计学意义(P<0.05),但两组对比,差异无统计学意义。37例患者成功获得影像学随访。张力带组术后再撕裂率15.0%(3例);缝合桥组术后再撕裂率11.7%(2例),差异无统计学意义。结论 两种术式临床疗效均显著,但单排张力带技术较缝合桥技术用时更短,值得临床推广。
Abstract
Objective To compare the clinical results of single-row tension-band technique and suture-bridge technique in the treatment of bursal-side partial thickness rotator cuff tears.Methods A total of 46 patients diagnosed with high-grade bursal-side partial thickness rotator cuff tears who underwent arthroscopic treatment using in situ trans-tendon repair between March 2017 and March 2018 in the Department of Orthopedics of Jiangxi Provincial Corps Hospital of Chinese People's Armed Police Force were retrospectively selected. Of the 46 patients, 25 underwent single-row tension-band technique (TB group) and 21 underwent suture-bridge technique (SB group). The operation time, pain visual analogue scale (VAS), Constant, and American Shoulder and Elbow Surgeons (ASES) scores were compared between the two groups. Postoperative rotator cuff retear was evaluated through MRI image after surgery using the Sugaya classification.Results All the 46 patients were followed up for 24-36 months. There were no complications such as vascular or nerve injury during the operation. The average operation time was significantly shorter in the TB group (55.52±8.21 minutes)than in the SB group(69.10±8.85 minutes)(P<0.05).At the final follow-up, the average VAS, Constant, and ASES scores in both groups improved significantly respectively(P<0.05),but no significant differences between the two groups. Thirty-seven patients underwent imaging follow-up successfully. At the final follow-up , the MRI assessments showed 3 retears in the TB group (15.0%) and 2 retears in the SB group (11.7%),but the difference was not statistically significant.Conclusions Two surgical methods in the treatment of bursal-side partial thickness rotator cuff tears can have significant clinical efficacy. The single-row tension-band technique is worth promoting clinically because it takes shorter time than the suture-bridge technique.
关键词
关节镜 /
滑囊面 /
肩袖部分撕裂 /
张力带技术 /
缝合桥技术
Key words
arthroscopy /
bursal-side /
partial thickness rotator cuff tears /
tension-band technique /
suture-bridge technique
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