肩袖撕裂合并冻结肩症状持续时间对手法松解下行肩袖修补术疗效的影响

Effect of symptom duration of rotator cuff tear with frozen shoulder onclinical efficacy of rotator cuff repair with manipulation release

目的本研究旨在探讨术前肩袖撕裂合并冻结肩症状持续时间对手法松解下行肩袖修补术预后的影响,为临床手术时机提供参考。方法通过回顾性分析我院行手法松解下肩袖修补术患者共计80例,分为A组40例:肩袖撕裂合并冻结肩症状持续时间≤3个月,B组40例:肩袖撕裂合并冻结肩症状持续时间>3个月并且<6个月。通过对比术前和术后疼痛视觉模拟评分(visual analogue scale,VAS),美国肩肘协会评分系统(ASES)和Constant⁃Murley评分以评估疗效。结果两组患者均顺利完成手法松解下肩袖修补术,两组患者术后6周、3个月、6个月VAS评分较术前均逐渐显著降低(P<0.05)、ASES评分及Constant⁃Murley评分较术前均逐渐显著升高(P<0.05),而术后6个月与术后12个月各项评分比较差异无统计学意义(P>0.05),两组患者组间VAS评分及ASES评分比较差异无统计学意义(P>0.05),Constant⁃Murley评分比较只有在术后6周时的差异有统计学意义(P<0.05)。结论肩袖撕裂合并冻结肩症状持续时间≤3个月的患者手法松解下行肩袖修补术比症状持续时间>3个月并<6个月的患者能较早获得肩关节活动的改善,但远期疗效差异无统计学意义。

Objective To investigate the effect of symptom duration of rotator cuff tear with frozen shoulder on clinical efficacy of rotator cuff repair with manipulation release and to provide reference for operation timing.Methods eighty patients which rotator cuff repair under manual release were retrospectively analyzed.They were divided into A group(n=40)the duration was less than or equal to 3 months and B group(n=40:the duration was more than 3 months and less than 6 months).VAS,ASES and Constant⁃Murley scores were compared before operation and post operation to evaluate the efficacy.Results The two groups of patients successfully went through the operation.The VAS scores of patients in both groups at 6 weeks,3 months and 6 months after operation grew gradually lower than those before operation(P<0.05),and ASES and Constant⁃Murley score increased gradually higher than those before operation(P<0.05).There was no statistical difference in VAS and ASES score between the two groups(P>0.05).The statistical difference of constant⁃Murley score was significant only at 6 weeks after operation(P<0.05).Conclusion The patients with the duration is less than or equal to 3 months can get the improvement of shoulder join activity earlier than the patients with the duration of more than 3 months and less than 6 months,but there is no significant difference concerning the long term curative effect.