肩关节镜下双排缝合桥固定与单排固定治疗中型肩袖撕裂的效果比较

Comparison of the effects of double-row suture bridge fixation and single-row fixation under shoulder arthroscopy in the treatment of medium-sized rotator cuff tear

目的比较肩关节镜下双排缝合桥固定与单排固定治疗中型肩袖撕裂的效果。方法选取广东省水电医院2019年6月至2021年12月收治的60例中型肩袖撕裂患者,以随机数字表法进行分组,将接受肩关节镜下双排缝合桥固定治疗的30例患者设为双排组,接受肩关节镜下单排固定治疗的30例患者设为单排组。比较两组的肩关节活动度、上肢运动功能、日常活动能力、并发症发生情况、再撕裂发生率与治疗满意度。结果术后1个月,两组的肩关节活动度均大于术前,且双排组大于单排组(P<0.05)。术后1个月,两组的美国肩肘外科协会(ASES)、Fugl-Meyer量表及Barthel指数评分均高于术前,且双排组高于单排组(P<0.05)。双排组的并发症总发生率与再撕裂发生率均低于单排组(P<0.05)。双排组的治疗满意度高于单排组(P<0.05)。结论对于中型肩袖撕裂患者的治疗,以肩关节镜下双排缝合桥固定治疗与单排固定治疗均可获得不错的效果,但前者会更明显地增大肩关节活动度,改善上肢运动功能及日常生活能力,减少术后并发症,尤其减少了术后肩关节再撕裂的发生,从而提升患者的治疗满意度。

Objective To compare the effects of double-row suture bridge fixation and single-row fixation under shoulder arthroscopy in the treatment of medium-sized rotator cuff tear.Methods A total of 60 patients with medium-sized rotator cuff tear admitted in Guangdong Hydropower Group Hospital from June 2019 to December 2021 were selected and grouped by random number table method.Thirty patients who received arthroscopic double-row suture bridge fixation treatment were included in double-row group,and 30 patients who received arthroscopic single-row fixation treatment were included in single-row group.The shoulder joint mobility,upper limb motor function,daily activity ability,complications,re-tear rate and treatment satisfaction were compared between the two groups.Results At 1 month after operation,the range of motion of shoulder joint in the two groups was greater than that before operation,and that in the double-row group was greater than that in the single-row group(P<0.05).At 1 month after operation,the scores of American Shoulder and Elbow Surgeons(ASES),Fugl-Meyer scale and Barthel index in the two groups were higher than those before operation,and those in the double-row group were higher than those in the single-row group(P<0.05).The total incidence of complications and the incidence of re-tear in the double-row group were lower than those in the single-row group(P<0.05).The treatment satisfaction of the double-row group was higher than that in the single-row group(P<0.05).Conclusion For the treatment of patients with medium-sized rotator cuff tears,the treatment of double-row suture bridge fixation and single-row fixation under shoulder arthroscopy can achieve good results,but the former will more significantly increase the range of motion of the shoulder joint,improve upper limb motor function and daily living ability,and reduce postoperative complications,especially reduce the occurrence of postoperative shoulder joint re-tear,so as to improve the patients'treatment satisfaction.