Aydin Ali, Yildiz Vahit, Kalali Fatih, Yildirim Omer Selim, Topal Murat, Dostbil Ayşenur
Department of Orthopaedics and Traumatology, Atatürk University, Medical School Hospital, Erzurum, Turkey.
Acta Orthop Belg. 2011 Dec;77(6):733-6.
This study investigated the role of acromion morphology in the aetiology of chronic subacromial impingement syndrome. Forty five patients with chronic subacromial impingement syndrome were included in the study. They were distributed into three groups according to their acromion types: six (13.3%) patients had type 1, 24 (533%) patients type 2 and 15 (333%) patients type 3 acromion. Constant scoring was used for clinical evaluation. Arthroscopic subacromial decompression was performed in all patients in the three groups, without performing any acromioplasty that would change the morphology of acromion. We then compared the average Constant scores changes in all three groups after arthroscopic subacromial decompression. The average follow-up was 28.6 months (range: 12-47). The average change in Constant score after arthroscopic subacromial decompression was 5830 in patients with type 1 acromion, 58.21 in those with type 2 and 54.07 in those with type 3. No significant difference was observed between the changes in the average Constant scores of the three groups (p > 0.005). The scores were significantly improved following arthroscopic subacromial decompression in all three groups (p < 0.005).In this study, acromion type was not found to have an important role in the aetiology of chronic impingement syndrome; arthroscopic subacromial decompression without simultaneous acromioplasty thus appears as an appropriate treatment.
本研究调查了肩峰形态在慢性肩峰下撞击综合征病因学中的作用。45例慢性肩峰下撞击综合征患者纳入本研究。根据肩峰类型将他们分为三组：6例（13.3%）为1型肩峰，24例（53.3%）为2型肩峰，15例（33.3%）为3型肩峰。采用Constant评分进行临床评估。三组所有患者均行关节镜下肩峰下减压术，未进行任何会改变肩峰形态的肩峰成形术。然后我们比较了关节镜下肩峰下减压术后三组患者Constant评分的平均变化。平均随访时间为28.6个月（范围：12 - 47个月）。关节镜下肩峰下减压术后，1型肩峰患者Constant评分的平均变化为58.30，2型肩峰患者为58.21，3型肩峰患者为54.07。三组患者Constant评分平均变化之间未观察到显著差异（p>0.05）。三组患者在关节镜下肩峰下减压术后评分均显著改善（p<0.005）。在本研究中，未发现肩峰类型在慢性撞击综合征病因学中起重要作用；因此，不进行同期肩峰成形术的关节镜下肩峰下减压术似乎是一种合适的治疗方法。
