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[巨大肩袖撕裂时肱二头肌长头腱成形术]

[Tenoplasty of the long head of the biceps in massive rotator cuff tear].

作者信息

Pavlidis T, Ganten M, Lehner B, Düx M, Loew M

机构信息

Stiftung Orthopädische Universitätsklinik Heidelberg, Abteilung für Schulter- und Ellenbogenchirurgie.

出版信息

Z Orthop Ihre Grenzgeb. 2003 Mar-Apr;141(2):177-81. doi: 10.1055/s-2003-38660.

Abstract

AIM

It was the aim of this study to investigate the success of biceps tenoplasty in massive interval rotator cuff tears.

METHOD

Fifteen patients, who had a massive rotator cuff tear in the area of the interval and a pathology of the long head of the biceps tendon, were examined clinically and by MRI. A primary reconstruction of the rotator cuff tear was possible in none of the patients. All patients had a secondary reconstruction with a biceps tenoplasty. The Constant Score was determined postoperatively and the satisfaction of the patients was explored.

RESULTS

The mean age at the time of the operation was 55 years. The examination was 23 months postoperatively. A simultaneous rupture of the supraspinatus- and subscapularis tendon was seen in 12 patients, an additional rupture of the infraspinatus tendon in 3 patients intraoperatively. The long head of the biceps was dislocated in 10 patients and subluxated in 5 patients. The postoperative determined Constant Score was 82.7 points. The personal satisfaction was investigated by asking for the German schoolmarks, which extend from 1 (excellent) to 6 (not satisfactory). The preoperative schoolmark was 5.2 and the postoperative schoolmark 1.4. In the MRI examination one rerupture could be seen, an atrophy of the supraspinatus tendon was evaluated in four patients. Knowing the postoperative result, all patients would have repeated the operation.

CONCLUSION

The biceps tenoplasty is a suitable operative method to achieve a better function and relief of pain in massive interval rotator cuff tears with simultaneous pathology of the long head of the biceps tendon. A high degree of personal satisfaction for the patient can be achieved.

摘要

目的

本研究旨在调查肱二头肌成形术治疗大范围肩袖间隙撕裂的成功率。

方法

对15例肩袖间隙区域存在大范围肩袖撕裂且肱二头肌长头有病理性改变的患者进行了临床检查和磁共振成像(MRI)检查。所有患者均无法进行肩袖撕裂的一期重建。所有患者均接受了肱二头肌成形术的二期重建。术后测定Constant评分,并探究患者的满意度。

结果

手术时的平均年龄为55岁。检查时间为术后23个月。术中发现12例患者同时存在冈上肌和肩胛下肌腱断裂,3例患者还存在冈下肌腱断裂。10例患者肱二头肌长头脱位,5例患者肱二头肌长头半脱位。术后测定的Constant评分为82.7分。通过询问德国学校评分来调查个人满意度,评分范围从1(优秀)到6(不满意)。术前评分为5.2,术后评分为1.4。在MRI检查中可见1例再撕裂,4例患者评估有冈上肌腱萎缩。了解术后结果后,所有患者都愿意再次接受手术。

结论

肱二头肌成形术是一种合适的手术方法,可在肱二头肌长头同时存在病理性改变的大范围肩袖间隙撕裂中实现更好的功能和缓解疼痛。患者可获得高度的个人满意度。

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