Department of Surgery, Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
J Shoulder Elbow Surg. 2012 Jan;21(1):72-6. doi: 10.1016/j.jse.2011.01.038. Epub 2011 Mar 12.
The majority of rotator cuff lesions involving the supraspinatus occur at or near the level of bone-tendon interface. We present a series of supraspinatus injuries at the musculotendinous junction.
Between October 2002 and December 2009, we prospectively evaluated all patients presenting with an injury of the supraspinatus at the musculotendinous junction.
Five patients (1 female and 4 males) were identified. Three patients had a clear history of trauma. All patients presented acutely with pain and muscular edema on T2 magnetic resonance imaging (MRI) sequences. Lesions were characterized as stretch injuries in 2 cases and complete rupture at the level of the musculotendinous junction in 3 cases. Electrodiagnostic studies were normal in all cases. All patients were treated nonoperatively. On clinical and radiological examination at an average of 24 ± 10 months (range, 10-38), 1 patient had complete clinical and radiological resolution, 1 improved, and 3 who complained of loss of function demonstrated severe fatty infiltration on MRI.
Musculotendinous rupture of the supraspinatus is an unusual lesion of the rotator cuff. With incomplete injuries, recovery can be anticipated with nonsurgical management. However, in the case of a complete rupture with muscle retraction, nonoperative management leads to unsatisfactory outcomes.
大多数累及冈上肌的肩袖病变发生在骨-肌腱交界处或其附近。我们报告一系列发生在冈上肌肌腱结合部的冈上肌损伤。
在 2002 年 10 月至 2009 年 12 月期间，我们前瞻性地评估了所有出现冈上肌肌腱结合部损伤的患者。
共发现 5 例患者（女性 1 例，男性 4 例）。3 例患者有明确的创伤史。所有患者均以急性疼痛和 T2 磁共振成像（MRI）序列上的肌肉水肿为特征。2 例为伸展损伤，3 例为完全断裂。所有病例的电诊断研究均正常。所有患者均接受非手术治疗。平均随访 24±10 个月（范围，10-38 个月），1 例患者临床和影像学完全恢复，1 例改善，3 例功能丧失患者 MRI 显示严重脂肪浸润。
冈上肌肌腱结合部的肌腱断裂是肩袖的一种不常见病变。对于不完全损伤，非手术治疗可以预期恢复。然而，对于完全断裂伴肌肉回缩的患者，非手术治疗的结果并不满意。
