肱二头肌长头腱切断结节间沟下关节外固定治疗老年SLAP损伤患者的疗效分析

Therapeutic effect analysis of long head of biceps brachii tendectomy and intertubercular sulcus extraarticular tenodesis for treatment of senile SLAP injury

目的分析肱二头肌长头腱切断结节间沟下固定治疗老年上盂唇前后部(superior labral anterior and posterior,SLAP)损伤患者的临床疗效。方法回顾性分析西南医科大学附属中医医院2014年1月至2015年1月行肩关节镜治疗的35例Ⅱ、Ⅳ型老年SLAP损伤患者的临床资料,其中肱二头肌长头腱切断结节间沟下关节外固定17例(A组),男9例、女8例,年龄51~68岁,平均58.6岁,左侧7例、右侧10例;肱二头肌长头腱切断关节内固定18例(B组),男11例、女7例,年龄51~68岁,平均59.8岁,左侧8例、右侧10例。术后循序渐进行功能康复锻炼,采用美国肩肘外科协会评分(America shoulder and elbow surgeons'form,ASES)和视觉模拟评分(visual analog scale,VAS)评价治疗效果。结果 35例患者均获随访,随访时间为1年。术后的ASES评分和VAS评分较术前明显改善,差异均有统计学意义(P<0.05),两组患者手术时间差异无统计学意义(P>0.05),所有患者均未发生神经损伤、伤口感染等并发症。结论肱二头肌长头腱切断结节间沟下关节外固定治疗老年SLAP损伤患者的临床疗效确切,是一种值得推广的治疗方法。

Background With the continuous improvement of people's life quality and the popularity of national sport,the number of people with athletic injury such as superior labral anterior and posterior(SLAP)lesion is on the rise.With the continuous development of minimally invasive shoulder arthroscopic technique and the increasing diagnostic level of shoulder joint disease,it is gradually realized that the SLAP lesion is an important factor which leads to shoulder dysfunction in clinic.The SLAP injury usually occurs in young people or special athletes.Pain is the main symptom,which increases during overhead throwing.Symptoms including interlocking,snapping and instability accompany sometimes,while complaints of instability are rare.Causes of SLAP lesion include the external force that affects biceps tendon,the instability of glenohumeral joint,etc.The rate of incidence for elderly is relatively low with degeneration as the common cause.Age is an important factor that affects the postoperative clinical result of SLAP repair.However,the elderly patient can still get good operation effects with effective postoperative rehabilitation therapy and the careful preoperative evaluation of patients'demands and operation risks.