Department of Orthopaedic and Trauma Surgery, University of Heidelberg, Heidelberg, Germany.
J Shoulder Elbow Surg. 2012 Jan;21(1):23-8. doi: 10.1016/j.jse.2011.07.013. Epub 2011 Oct 20.
The purpose of this study was to investigate the etiology and the demographic and functional characteristics of rotator cuff tears (RCTs) in 100 paraplegic patients as compared with 100 able-bodied volunteers.
The magnetic resonance imaging examination results of 200 shoulders in each group were analyzed. Clinical examination included the Constant score and a visual analog scale for pain intensity.
The prevalence of RCTs was 63% in paraplegic patients versus 15% in able-bodied volunteers (P < .0001). All RCTs in the paraplegic group were associated with symptoms. Among the patients with RCTs, full-thickness tears were detected in 78% of cases in the paraplegic patient group versus 73% of cases in the volunteer group. The rate of partial-thickness tears was 22% in the paraplegic group versus 27% in the volunteer group. Paraplegic patients had a lower Constant score; Disabilities of the Arm, Shoulder and Hand score; and range of motion and a higher pain intensity than the volunteer cohort. The mean tear width in paraplegic patients was 14.4 mm (range, 8-28 mm) versus 9.9 mm (range, 8-14 mm) in the volunteers (P < .01).
The etiology of RCTs in paraplegic patients seems to be based on wear-and-tear mechanisms rather than aging. These results are important for our understanding of shoulder pathology in long-term paraplegic patients and show the impact of this problem.
本研究旨在调查 100 例截瘫患者与 100 例健康志愿者的肩袖撕裂（RCT）病因以及人口统计学和功能特征。
分析每组 200 例肩部的磁共振成像检查结果。临床检查包括 Constant 评分和疼痛强度视觉模拟评分。
截瘫患者的 RCT 患病率为 63%，而健康志愿者为 15%（P <.0001）。截瘫组所有 RCT 均与症状相关。在有 RCT 的患者中，完全撕裂在截瘫患者组中占 78%，在志愿者组中占 73%。部分撕裂在截瘫组中占 22%，在志愿者组中占 27%。截瘫患者的 Constant 评分、上肢功能障碍评分、活动范围和疼痛强度均低于志愿者组。截瘫患者的平均撕裂宽度为 14.4 毫米（范围，8-28 毫米），志愿者组为 9.9 毫米（范围，8-14 毫米）（P <.01）。
截瘫患者 RCT 的病因似乎基于磨损机制而非老化。这些结果对于我们理解长期截瘫患者的肩部病理很重要，并显示了这个问题的影响。
