肩关节镜对肩部疾病的辅助诊断和治疗

Evaluation of Arthroscopy in Shoulder Surgery

目的：对肩关节镜技术作为肩关节疾病的辅助诊断和治疗手段进行初步探讨。材料和方法：总结近年作者开展肩关节镜２５例，２６个肩关节，１６例同时行肩峰下滑囊镜检。其中冻结肩３例，肩袖撕裂６例，肩袖间隙撕裂２例，复发性肩关节脱位５例，肩关节后下方半脱位１例，肩峰撞击征（Ⅱ期）３例。肩关节类风湿性关节炎１例，肩盂或肱骨头粉碎骨折４例。镜下手术操作７例，其中镜下肩峰外侧端成形手术３例，复发性肩关节脱位和肩袖撕裂患者合并肩胛盂唇舌瓣样撕裂各１例行镜下切除，１例肩关节镜下滑膜切除，１例关节内游离骨片摘除术。结果：７例镜下手术，术后平均随访１６个月，优４例，良２例，进步１例。结论：辅助性肩关节镜的优点在于可直接观察和处理肩肱关节和肩峰下关节内病变，明确诊断，指导手术方法选择，镜下手术创伤小，术后康复快。

Objective: To evaluate the efficacy of the arthroscopy in the diagnosis and treatment of the patient with shoulder disorders. Methods: Twentysix shoulder arthroscopies were performed on 25 patients. Of those, 16 underwent examination of subcromial bursa through arthroscopy at the same setting. The diagnosis includes frozen shouder in 3 cases, rotator cuff tear in 6,recurrent dislocation of shoulder in 6, subacromial impingement syndrome in 3, Rotator interval separation in 2, Rheumatoid arthritis in 1 and shoulder fracture in 4 cases. One of them suffered from traumatic shoulder dislocation and with a loss of bony fragment inside glenohumeral joint. Seven patients accepted arthroscopic surgery, including acromioplasty in 3 cases, torn glenoid labrum resection in 2 cases, removed of bony fragment and synovectomy each in one case. Results: Seven patients who accepted arthroscopic surgery were followed up an average of 16 months postoperatively; excellent or good results were seen in 6 cases. Conclusion: Shoulder joint arthroscopy will benefit to make a definite diagnosis, get more information for planning the operative procedure.