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背阔肌转移术治疗不可修复性肩袖撕裂的疗效

Outcome of latissimus dorsi transfer for irreparable rotator cuff tears.

作者信息

Debeer Philippe, De Smet Luc

机构信息

Department of Musculoskeletal Science, University Hospital Pellenberg, Leuven Belgium.

出版信息

Acta Orthop Belg. 2010 Aug;76(4):449-55.

Abstract

The aim of this retrospective study was to assess the mid- and long-term functional and radiological results following latissimus dorsi transfer for symptomatic irreparable tears of the supra- and infraspinatus tendons (postero-superior cuff tears). Twenty-six shoulders with an irreparable posterosuperior rotator cuff tear were assessed preoperatively and after latissimus dorsi transfer, using the Constant score and standard radiographs to determine the degree of osteoarthritis and to measure the acromio-humeral distance. After a minimal follow-up of one year (range: 13 to 124 months) we observed a significant increase in Constant score from 39 to 60 points at the time of the last follow-up (p < 0.00001). Eighty-five percent of the patients were satisfied or very satisfied with the result and would undergo the same surgery again. An increase in the grade of gleno-humeral osteoarthritis was noted in 38.5% of the operated shoulders, and this was associated with a lower Constant score. We noted a decrease in acromio-humeral distance, indicating further proximalisation of the humeral head, but this was not significant (p = 0.049).

摘要

本回顾性研究的目的是评估背阔肌转移治疗有症状的冈上肌和冈下肌肌腱不可修复性撕裂(后上盂唇撕裂)后的中长期功能和影像学结果。对26例患有不可修复性后上肩袖撕裂的肩部进行术前和背阔肌转移术后评估,使用Constant评分和标准X线片来确定骨关节炎程度并测量肩峰-肱骨头距离。在至少随访一年(范围:13至124个月)后,我们观察到末次随访时Constant评分从39分显著提高至60分(p < 0.00001)。85%的患者对结果满意或非常满意,愿意再次接受相同手术。38.5%的手术肩部出现了盂肱关节骨关节炎分级增加,这与较低的Constant评分相关。我们注意到肩峰-肱骨头距离减小,表明肱骨头进一步向上移位,但差异无统计学意义(p = 0.049)。

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