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冈上肌腱部分关节面肌腱撕裂损伤不同手术方式的比较研究

A comparative study of different surgical methods for partial articular surface tendon avulsions injury

摘要目的:比较关节镜下Ellman 3度冈上肌腱部分关节面肌腱撕裂(PASTA)损伤不同手术方法的临床效果。方法:选取2017年1月至2018年12月滕州市中心人民医院关节运动医学科收治的47例因冈上肌腱关节面侧部分撕裂行手术治疗的患者,男31例,女16例,年龄(49.7±4.4)岁,年龄范围为34~70岁,所选患者均为Ellman 3度,按手术方法不同分为穿肌腱修补组( n=24)和转化为全层后修补组( n=23),比较患者术前、术后6个月和术后12个月时两组患者的Constant评分、美国肩肘外科协会 (ASES)评分、美国加州大学肩关节(UCLA)评分,评价肩关节功能。 结果:术后随访时间12个月,两组患者术后6个月、术后12个月随访的Constant评分[(73.4±6.5)分、(73.1±6.5)分,(83.0±4.9)分、(84.3±5.8)分]、ASES评分[(76.6±5.2)分、(77.4±3.7)分,(84.3±5.2)分、(84.6±5.3)分]、UCLA评分[(28.3±2.6)分、(28.5±1.9)分,(33.7±1.5)分、(33.0±1.9)分]均高于术前[(30.4±5.6)分、(31.2±4.7)分,(36.9±5.3)分、(37.8±4.9)分,(8.3±3.1)分、(9.3±3.2)分],差异有统计学意义( P<0.001)。两组患者术前、术后6个月、术后12个月随访的三项肩关节功能评分比较,差异均无统计学意义( P>0.05)。 结论:穿肌腱修补法和转化为全层后修补法均可获得满意的临床效果。

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abstractsObjective:To compare the clinical effect of different surgical methods for Ellman 3-degree partial articular surface tendon avulsions(PASTA)injury under arthroscopy.Methods:A retrospective study was performed on 47 cases of patients with PASTA injury who were admitted in department of Joint Surgery of The Tengzhou Center People′s Hospital, from January 2017 to December 2018.There were 31 males and 16 females, aged(49.7±4.4)years old, ranging from 34 to 70 years old.All the patients were all Ellman 3 degrees, and were divided into the transtendon repair group( n=24)and the tear completion and repair group( n=23)according to different surgical methods.Constant score, rating scale of the American shoulder and elbow surgeons(ASES)score and the university of California at Los Angeles shoulder rating(UCLA)score of patients in the two groups were compared before and at 6 months after surgery and 12 months after surgery to evaluate shoulder joint function. Results:The postoperative follow-up time was 12 months.The patients in the two groups received Constant score[(73.4±6.5)points, (73.1±6.5)points, (83.0±4.9)points, (84.3±5.8)points], ASES score[(76.6±5.2)points, (77.4±3.7)points, (84.3±5.2)points, (84.6±5.3)points], UCLA score[(28.3±2.6)points, (28.5±1.9)points, (33.7±1.5)points, (33.0±1.9)points]at 6 months and 12 months after surgery were higher than those before surgery[(30.4±5.6)points, (31.2±4.7)points, (36.9±5.3)points, (37.8±4.9)points, (8.3±3.1)points, (9.3±3.2)points], and the differences were statistically significant( P<0.001). There was no significant difference in the scores of shoulder joint function between the two groups before surgery, 6 months after surgery and 12 months after surgery( P>0.05). Conclusion:Transtendon repair method and repairs after tear completion method can achieve satisfactory clinical results.

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