40岁以后肩关节脱位伴肩袖撕裂治疗

Anterior Dislocation of the Shoulder Joint and Rotator Cuff over the 5th Decades of Age

目的 :对 40岁以后中年肩关节脱位和合并肩袖撕裂观察各种手术治疗结果。对象及方法 :选肩关节脱位而入院后发现合并肩袖撕裂患者 12例 ,患者年龄为 42～ 67岁 ,其中 2例有腋神经损伤伴大结节骨折。 12例均有肩袖撕裂 ,其中 8例广泛撕裂 ,3例中等撕裂 ,1例轻度撕裂。结果 :肩关节脱位伴肩袖撕裂行肩袖缝合术除伴 2例腋神经损伤者外 ,10例用UCLA肩关节功能评定 ,评价时术后肩关节功能良好。结论 :中年以上肩关节脱位时需用关节镜明确诊断 ,有腋神经损伤合并肩袖撕裂者需合适的肩袖缝合及腋神经康复治疗。

Objective:To evaluate the prognostic factors of the rotator cuff tear after anterior dislocation of the shoulder joint over the 5th decades of age.Methods:We evaluated twelve patients who had rotator cuff tears combined with primary anterior dislocation of the glenohumeral joint between May.1995 and Oct.1998,aged from 42 to 67 years old.Two of them were initially presumed to have an injury of the axillary nerve and associated with avulsion fracture of the greater tuberosity.Among the twelve patients,8 cases had massive,3 cases had medium and one case had a small sized tear.Results:All the tears of the rotater cuff were repaired and the results were obtained by UCLA shoulder rating scale.Ten cases of them revealed more than good results except for 2 cases who had had unhappy shoulder injury and auxillary nerve injury.Conclusions:In case of anterior dislocation of shoulder,it is necessary to check the injury of rotator cuff and auxillary nerve in the middle age group.If these injuries are combined,proper rotator cuff repair and auxillary nerve rehabilitation program would be asked for better results.