关节镜下肩袖损伤合并肱二头肌长头腱断裂不同的固定方式对肩关节功能恢复的影响分析

Analysis of the effects of different fixation methods on the recovery of shoulder function in patients with rotator cuff injury combined with biceps long head tendon rupture under arthroscopy

目的探究和分析挤压钉固定(IS)和带线锚钉缝合套扎固定(SA)两种固定方式对关节镜下肩袖损伤合并二头肌长头腱断裂手术治疗患者肩关节功能恢复的影响。方法选取南昌市第三医院2018年1月-2022年5月收治的肩袖损伤合并肱二头肌长头腱断裂患者60例作为研究对象,依据患者的术中固定方式将患者分为IS组(n=32)和SA组(n=28),对患者功能活动评分法(FAS)、美国加州大学肩关节评分系统(UCLA)、美国肩与肘协会评分系统(ASES)各项评分及大力水手征畸形、血管神经损伤、深部感染、固定移位松动、肌肉痤李、肌腱粘连的并发症发生率进行回顾性分析和比较。结果重复测量方差分析发现,不同时间点的FAS、UCLA、ASES评分均具有统计学差异(P<0.05),时间和组别间存在交互作用(P<0.05),组别间方差分析结果具有统计学意义(P<0.05)。两组患者FAS评分随着时间均呈现下降趋势,UCLA、ASES评分随时间呈现上升趋势。两组患者为期1年的随访追踪中,SA组发生2起肌腱粘连(7.14%)的并发症。结论挤压钉固定和带线锚钉缝合套扎固定均能为患者提供良好的修复固定效果,但带线锚钉缝合套扎固定可能在短期内会给患者带来更明显的疼痛感受和更高的并发症发生率。

Objective To explore and analyze the effects of two fixation methods,including compression screw fixation(IS)and suture anchor lacing fixation(SA),on the recovery of shoulder function in patients with rotator cuff injury combined with biceps long head tendon rupture under arthroscopy.Method Sixty patients with rotator cuff injury combined with biceps long head tendon rupture admitted to our hospital from January 2018 to May 2022 were selected as the research objects.According to the intraoperative fixation methods of the patients,the patients were divided into IS group(n=32)and SA group(n=28).The functional activity score(FAS),University of California shoulder score(UCLA),American shoulder and elbow society score(ASES)and the incidence of complications such as Popeye's sign deformity,vascular and nerve injury,deep infection,loosening of fixation displacement,muscle spasm,and tendon adhesion were retrospectively analyzed and compared.Result Repeated measures analysis of variance showed that the FAS,UCLA,and ASES scores at different time points were statistically different(P<0.05),there was an interaction between time and groups(P<0.05),and the results of analysis of variance between groups were statistically significant(P<0.05).The FAS score of the two groups showed a downward trend with time,while the UCLA and ASES scores showed an upward trend with time.During the one-year follow-up of the two groups,2 cases of tendon adhesion(7.14%)occurred in the SA group.Conclusion Both compression nail fixation and suture anchor ligation fixation can provide good repair and fixation effects for patients,but suture anchor ligation fixation may bring more obvious pain and higher incidence of complications in the short term.