Department of Anesthesiology and Pain Medicine, Kang-Dong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
Korean J Pain. 2011 Jun;24(2):69-73. doi: 10.3344/kjp.2011.24.2.69. Epub 2011 Jun 3.
Although the incidence of partial-thickness rotator cuff tears (PTRCTs) was reported to be from 13% to 32% in cadaveric studies, the actual incidence is not yet known. The causes of PTRCTs can be explained by either extrinsic or intrinsic theories. Studies suggest that intrinsic degeneration within the rotator cuff is the principal factor in the pathogenesis of rotator cuff tears. Extrinsic causes include subacromial impingement, acute traumatic events, and repetitive microtrauma. However, acromially initiated rotator cuff pathology does not occur and extrinsic impingement does not cause pathology on the articular side of the tendon. An arthroscopic classification system has been developed based on the location and depth of the tear. These include the articular, bursal, and intratendinous areas. Both ultrasound and magnetic resonance image are reported with a high accuracy of 87%. Conservative treatment, such as subacromial or intra-articular injections and suprascapular nerve block with or without block of the articular branches of the circumflex nerve, should be considered prior to operative treatment for PTRCTs.
尽管尸检研究报道部分厚度肩袖撕裂（PTRCT）的发生率为 13%至 32%，但实际发生率尚不清楚。PTRCT 的原因可以用外在或内在理论来解释。研究表明，肩袖内的内在变性是肩袖撕裂发病机制的主要因素。外在原因包括肩峰下撞击、急性创伤事件和反复微创伤。然而，肩峰下起始的肩袖病理并不发生，外在撞击也不会导致肌腱关节侧的病理。已经开发了一种基于撕裂位置和深度的关节镜分类系统。这些包括关节、滑囊和腱内区域。超声和磁共振成像均具有 87%的高准确性报告。对于 PTRCT，应在手术治疗之前考虑保守治疗，如肩峰下或关节内注射以及肩胛上神经阻滞，加上或不加上旋肱前神经关节支阻滞。
