Conti M, Garofalo R, Castagna A
Shoulder and Elbow Unit, IRCCS, Humanitas Institute, Milan, Italy.
Shoulder Service F Miulli Hospital, Acquaviva delle fonti, Bari, Italy.
Musculoskelet Surg. 2015 Sep;99 Suppl 1:S31-5. doi: 10.1007/s12306-015-0357-0. Epub 2015 May 10.
The goal of this study was to report the clinical effects of two different braces after rotator cuff repair.
Forty patients who underwent an arthroscopic rotator cuff repair were prospectively allocated in this study. Twenty patients were immobilized in 15° external rotation brace (ER Group), and twenty were immobilised in an internal rotation sling (IR Group). For all patients, four surveys were done: in the immediate pre-operative period (T0), at 1 month (T1), at 3 months (T2) and at 6 months after surgery (T3). Range of motion and pain were evaluated by an independent physician. Self-Assessment Scales [(University California Los Angeles Shoulder Rating Scale (UCLA), Disability of the Arm Shoulder and Hand (DASH), Visual Analog Scale (VAS), Simple Shoulder Test (SST) and Physician Assessment Scale (Constant)] were also administered.
Abduction and ER2 (external rotation with arm in abduction) were significantly greater in the ER group at T1, T2 and T3, ER1 (external rotation with arm at side) was significantly greater in the ER group at T1 and T2, IR2 (internal rotation) was significantly greater in the ER group at T1, and FFL (forward flexion) was significantly greater in the ER group at T1. VAS was significantly lower in the ER group at T1 and T2 and T3. About the Self-Assessment Shoulder Scales after 3 and 6 months, no differences were found. SST showed a lesser functional limitation for the ER group at T3.
Patients operated with isolated superior or posterosuperior rotator cuff tear immobilised with brace in 15° of ER position showed less pain and a better passive range of motion at short time after surgery.
本研究的目的是报告肩袖修复术后两种不同支具的临床效果。
本研究前瞻性纳入了40例行关节镜下肩袖修复术的患者。20例患者佩戴外旋15°支具固定（外旋组），20例患者佩戴内旋吊带固定（内旋组）。对所有患者进行了四项调查：术前即刻（T0）、术后1个月（T1）、3个月（T2）和6个月（T3）。由一名独立医生评估活动范围和疼痛情况。还使用了自我评估量表[加州大学洛杉矶分校肩评分量表（UCLA）、上肢肩部手部功能障碍量表（DASH）、视觉模拟量表（VAS）、简易肩部测试（SST）和医生评估量表（Constant）]。
外旋组在T1、T2和T3时的外展和外旋2（外展时的外旋）显著更大，外旋组在T1和T2时的外旋1（手臂位于身体一侧时的外旋）显著更大，外旋组在T1时的内旋2（内旋）显著更大，外旋组在T1时的前屈显著更大。外旋组在T1、T2和T3时的VAS显著更低。关于术后3个月和6个月的自我评估肩部量表，未发现差异。SST显示外旋组在T3时功能受限较小。
对于单纯性上或后上肩袖撕裂行手术治疗的患者，使用外旋15°支具固定，术后短期内疼痛较轻，被动活动范围更好。
