关节镜辅助小切口治疗肩袖损伤25例分析

Clinical Analysis of Arthroscope-assisted Small Incision Approach for the Treatment of 25 Cases of Rotator Cuff Injury

【目的】探讨关节镜辅助下小切口治疗肩袖损伤的手术技巧和临床疗效。【方法]自2008年1月至2010年2月收治25例肩袖损伤患者，采用关节镜下辅助小切口修复肩袖损伤，手术均采用smith＆nephew带线铆钉进行肩袖重建。分别在术前及最终随访时采用美国肩肘医师协会评分（ASES）、Constan〉Murley评分以及简易肩关节评分（SST）问卷进行功能恢复评估。【结果】本组25例均获得随访，随访时间6～15个月，平均10．5个月。25例患者手术前及最终随访时ASES平均分（75．2VS89．1），差异有显著性（P〈0．01），且VAS疼痛评分（6．1VS2．2）（P〈0．001），肩关节平均上举幅度（77．6°VS136．6°）（P〈0．001），平均外旋幅度（25．5°VS40．2°）（P〈0．01），平均Constant—Murley评分（72．1VS88．6）（P〈0．01）。手术前后比较差异均有显著性（P〈0．01）。【结论】关节镜辅助小切口治疗肩袖损伤具有操作安全、较常规切开手术创伤小、有利于早期功能锻炼的优点，是治疗肩袖损伤的有效方法。

[Objective] To explore the surgical techniques and clinical efficacy of arthroscope-assisted small incision approach for the treatment of rotator cuff injury. [Methods] From January 2008 to February 2010, 25 cases of rotator cuff injury were treated by arthroscope-assisted small incision. All the rotator cuff injuries were reconstructed with smith ＆ nephew suture anchors. The functional recovery was evaluated by American Shoulder ＆ Elbow Doctor Association Score（ASES）, Constant-Murley score and simple shoulder test（SST） questionnaire before operation and at the latest follow up. [Results] All the 25 patients were followed up for 6 to 15 months with the average of 10.5 months. The mean ASES scores before and after operation were 75.2 vs. 89.1（/9 d0.01）, and the mean VAS scores for pain were 6.1 vs. 2.2（ P 〈0. 001）, and the mean forward flexion were 77.6° vs. 136.6° （ P 〈0. 001）, and the mean external rotation were 25.5° vs. 40. 2°（ P 〈0.01）, and Constant-Murley scores were 72.1 vs. 88.6 （ P 〈0.01）. [Conclusion] Arthroscope-assisted small incision approach for the treatment of rotator cuff injury has such advantages as minimal invasion, safety, early rehabilitation and rapid recovery. It is an effective treatment method for rotator cuff injury.