目的研究肩关节镜下Suture Bridge双排法手术修复中型肩袖撕裂的临床效果。方法选取2019年2月至2020年3月的150例肩袖损伤患者进行研究。按照随机数表法,分为观察组(n=79)和对照组(n=71)。对照组采用单排修复术治疗,观察组采用Suture Br...目的研究肩关节镜下Suture Bridge双排法手术修复中型肩袖撕裂的临床效果。方法选取2019年2月至2020年3月的150例肩袖损伤患者进行研究。按照随机数表法,分为观察组(n=79)和对照组(n=71)。对照组采用单排修复术治疗,观察组采用Suture Bridge双排法手术治疗。对比两组肩关节Constant评分、视觉模拟评分法评分(Visual Analogue Scale/Score,VAS)、美国加州大学肩关节评分系统评分(University of California at Los Angeles Shoulder Scores,UCLA)及愈合时间、康复时间及再撕裂率。结果治疗后3个月,观察组的Constant评分明显高于对照组(P<0.05);观察组治疗后3个月、治疗后1年VAS评分[(2.17±0.60、3.79±1.01)分]明显低于对照组(P<0.05);观察组UCLA评分总分、疼痛、功能、前屈角度、前屈肌力均明显高于对照组(P<0.05);愈合时间、康复时间及再撕裂率明显低于对照组(P<0.05)。结论肩关节镜下Suture Bridge双排法手术在修复中型肩袖撕裂上可取得良好的治疗效果,改善肩袖关节功能,值得推广。展开更多
BACKGROUND Most greater tuberosity fractures can be treated without surgery but some have a poor prognosis.The surgical procedures for avulsion fractures of the humeral greater tuberosity include screw fixation,suture...BACKGROUND Most greater tuberosity fractures can be treated without surgery but some have a poor prognosis.The surgical procedures for avulsion fractures of the humeral greater tuberosity include screw fixation,suture anchor fixation,and plate fixation,all of which have treatment-associated complications.To decrease surgical complications,we used a modified suture bridge procedure under direct vision and a minimally invasive small incision to fix fractures of the greater tuberosity of the humerus.AIM To investigate the clinical efficacy and outcomes of minimally invasive modified suture bridge open reduction of greater tuberosity evulsion fractures.METHODS Sixteen patients diagnosed between January 2016 and January 2019 with an avulsion-type greater tuberosity fracture of the proximal humerus and treated by minimally invasive open reduction and modified suture bridges with anchors were studied retrospectively.All were followed up by clinical examination and radiographs at 3 and 6 wk,3,6 and 12 mo after surgery,and thereafter every 6 mo.Outcomes were assessed preoperatively and postoperatively by a visual analog scale(VAS),the University of California Los Angeles(UCLA)shoulder score,the American Shoulder and Elbow Surgeon score(ASES),and range of motion(ROM)for shoulders.RESULTS Seven men and nine women,with an average age of 44.94 years,were evaluated.The time between injury and surgery was 1-2 d,with an average of 1.75 d.The mean operation time was 103.1±7.23 min.All patients achieved bone union within 3 mo after surgery.VAS scores were significantly decreased(P=0.002),and the mean degrees of forward elevation(P=0.047),mean degrees of abduction(P=0.035),ASES score(P=0.092)were increased at 3 wk.The UCLA score was increased at 6 wk(P=0.029)after surgery.The average degrees of external rotation and internal rotation both improved at 3 mo after surgery(P=0.012 and P=0.007,respectively).No procedure-related deaths or incision-related superficial or deep tissue infections occurred.CONCLUSION Modified suture bridge was effective for the treatment of greater tuberosity evulsion fractures,was easier to perform,and had fewer implants than other procedures.展开更多
BACKGROUND In rotator cuff repair surgery,the double-row technique is widely performed.Studies have shown that with increased contact area and pressure between tendon and bone interface,better healing is promoted.AIM ...BACKGROUND In rotator cuff repair surgery,the double-row technique is widely performed.Studies have shown that with increased contact area and pressure between tendon and bone interface,better healing is promoted.AIM To assess the different suture configurations with the double-row technique and how this influences the contact area of the rotator cuff tendon to bone.METHODS This was a controlled laboratory study where identical tears were created in 24 fresh porcine shoulders over a 1.5 cm×2.5 cm infraspinatus insertion footprint.Double-row repair techniques,with 3 to 4-suture anchors in different configurations(2 medial,2 lateral vs 2 medial,1 lateral vs 1 medial,2 lateral),were employed for three control groups.Each group consisted of eight shoulders with identical repair configurations.Footprint contact areas of the repaired tendon against the tuberosity were determined using pressure sensitive Fujifilm placed between the tendon and tuberosity.RESULTS The mean contact area between tendon and insertion footprint from the imprinted Fujifilm was obtained using computer software.The contact area measured from a standard 4-suture anchor double row repair was 75.1±9.3 mm2,whereas areas obtained for the 2 lateral-1 medial and 2 medial-1 lateral anchor configurations were 72.9±5.2 mm2 and 75.0±4.9 mm2 respectively.No statistical significance was noted between the three groups.CONCLUSION In the technique of double-row repair,using a 3-suture anchor configuration may offer a non-inferior alternative to the standard 4-anchor construct in terms of efficacy.This may also result in overall cost reduction and shorter surgical time.展开更多
文摘目的研究肩关节镜下Suture Bridge双排法手术修复中型肩袖撕裂的临床效果。方法选取2019年2月至2020年3月的150例肩袖损伤患者进行研究。按照随机数表法,分为观察组(n=79)和对照组(n=71)。对照组采用单排修复术治疗,观察组采用Suture Bridge双排法手术治疗。对比两组肩关节Constant评分、视觉模拟评分法评分(Visual Analogue Scale/Score,VAS)、美国加州大学肩关节评分系统评分(University of California at Los Angeles Shoulder Scores,UCLA)及愈合时间、康复时间及再撕裂率。结果治疗后3个月,观察组的Constant评分明显高于对照组(P<0.05);观察组治疗后3个月、治疗后1年VAS评分[(2.17±0.60、3.79±1.01)分]明显低于对照组(P<0.05);观察组UCLA评分总分、疼痛、功能、前屈角度、前屈肌力均明显高于对照组(P<0.05);愈合时间、康复时间及再撕裂率明显低于对照组(P<0.05)。结论肩关节镜下Suture Bridge双排法手术在修复中型肩袖撕裂上可取得良好的治疗效果,改善肩袖关节功能,值得推广。
基金China Scholarship Council,No.201808080126Incubation Fund of Shandong Provincial Hospital,No.2020FY019+1 种基金Young Scholars Program of Shandong Provincial HospitalNatural Science Foundation of Shandong Province,No.ZR202102180575.
文摘BACKGROUND Most greater tuberosity fractures can be treated without surgery but some have a poor prognosis.The surgical procedures for avulsion fractures of the humeral greater tuberosity include screw fixation,suture anchor fixation,and plate fixation,all of which have treatment-associated complications.To decrease surgical complications,we used a modified suture bridge procedure under direct vision and a minimally invasive small incision to fix fractures of the greater tuberosity of the humerus.AIM To investigate the clinical efficacy and outcomes of minimally invasive modified suture bridge open reduction of greater tuberosity evulsion fractures.METHODS Sixteen patients diagnosed between January 2016 and January 2019 with an avulsion-type greater tuberosity fracture of the proximal humerus and treated by minimally invasive open reduction and modified suture bridges with anchors were studied retrospectively.All were followed up by clinical examination and radiographs at 3 and 6 wk,3,6 and 12 mo after surgery,and thereafter every 6 mo.Outcomes were assessed preoperatively and postoperatively by a visual analog scale(VAS),the University of California Los Angeles(UCLA)shoulder score,the American Shoulder and Elbow Surgeon score(ASES),and range of motion(ROM)for shoulders.RESULTS Seven men and nine women,with an average age of 44.94 years,were evaluated.The time between injury and surgery was 1-2 d,with an average of 1.75 d.The mean operation time was 103.1±7.23 min.All patients achieved bone union within 3 mo after surgery.VAS scores were significantly decreased(P=0.002),and the mean degrees of forward elevation(P=0.047),mean degrees of abduction(P=0.035),ASES score(P=0.092)were increased at 3 wk.The UCLA score was increased at 6 wk(P=0.029)after surgery.The average degrees of external rotation and internal rotation both improved at 3 mo after surgery(P=0.012 and P=0.007,respectively).No procedure-related deaths or incision-related superficial or deep tissue infections occurred.CONCLUSION Modified suture bridge was effective for the treatment of greater tuberosity evulsion fractures,was easier to perform,and had fewer implants than other procedures.
文摘BACKGROUND In rotator cuff repair surgery,the double-row technique is widely performed.Studies have shown that with increased contact area and pressure between tendon and bone interface,better healing is promoted.AIM To assess the different suture configurations with the double-row technique and how this influences the contact area of the rotator cuff tendon to bone.METHODS This was a controlled laboratory study where identical tears were created in 24 fresh porcine shoulders over a 1.5 cm×2.5 cm infraspinatus insertion footprint.Double-row repair techniques,with 3 to 4-suture anchors in different configurations(2 medial,2 lateral vs 2 medial,1 lateral vs 1 medial,2 lateral),were employed for three control groups.Each group consisted of eight shoulders with identical repair configurations.Footprint contact areas of the repaired tendon against the tuberosity were determined using pressure sensitive Fujifilm placed between the tendon and tuberosity.RESULTS The mean contact area between tendon and insertion footprint from the imprinted Fujifilm was obtained using computer software.The contact area measured from a standard 4-suture anchor double row repair was 75.1±9.3 mm2,whereas areas obtained for the 2 lateral-1 medial and 2 medial-1 lateral anchor configurations were 72.9±5.2 mm2 and 75.0±4.9 mm2 respectively.No statistical significance was noted between the three groups.CONCLUSION In the technique of double-row repair,using a 3-suture anchor configuration may offer a non-inferior alternative to the standard 4-anchor construct in terms of efficacy.This may also result in overall cost reduction and shorter surgical time.
