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创伤性全层经肌腱性肩袖撕裂:病例系列

Traumatic full-thickness transtendinous rotator cuff tears: a case series.

作者信息

Walcott Marie E, Daniels Stephen D, Sinz Nathan J, Field Larry D, Higgins Laurence D

机构信息

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA; Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.

出版信息

J Shoulder Elbow Surg. 2017 Jan;26(1):62-67. doi: 10.1016/j.jse.2016.04.023. Epub 2016 Jul 14.

Abstract

HYPOTHESIS

Our purpose was to describe an arthroscopic repair technique for and outcomes of traumatic transtendinous rotator cuff tears affecting the supraspinatus tendon.

MATERIALS AND METHODS

A retrospective review was performed on a series of patients between January 2009 and January 2012. Demographic data, as well as preoperative and postoperative clinical data including strength, visual analog scale pain score, Subjective Shoulder Value, American Shoulder and Elbow Surgeons score, and Simple Shoulder Test score, were obtained.

RESULTS

Seven patients were identified with magnetic resonance imaging showing full-thickness, transtendon supraspinatus tears with extension into the infraspinatus, which were consistent with physical examination and arthroscopic findings. The mechanism of injury was traumatic in all cases, usually a fall with the arm abducted. The mean remaining stump of tendon measured 1.3 cm. All patients underwent open or arthroscopic repair by a side-to-side (tendon-to-tendon) technique with additional suture anchor augmentation. At an average follow-up of 41.5 months (range, 33-50 months), all patients had postoperative improvements in strength and visual analog scale pain scores (range, 0-1), as well as Subjective Shoulder Value, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores greater than 90.

CONCLUSION

We have described the occurrence of a rare rotator cuff tear in the purely tendinous portion of the muscle, leaving at least 1 cm of tendon attached to an intact footprint. We also have presented an arthroscopic side-to-side repair technique and postoperative outcomes. To our knowledge, this is the first article describing this uncommon rotator cuff tear.

摘要

假设

我们的目的是描述一种用于治疗影响冈上肌腱的创伤性经肌腱肩袖撕裂的关节镜修复技术及其结果。

材料与方法

对2009年1月至2012年1月期间的一系列患者进行回顾性研究。获取人口统计学数据以及术前和术后的临床数据,包括力量、视觉模拟评分疼痛评分、主观肩关节评分、美国肩肘外科医师评分和简单肩关节测试评分。

结果

7例患者经磁共振成像显示冈上肌全层经肌腱撕裂并延伸至冈下肌,这与体格检查和关节镜检查结果一致。所有病例的损伤机制均为创伤性,通常是手臂外展时摔倒。肌腱平均剩余残端为1.3厘米。所有患者均采用侧对侧(肌腱对肌腱)技术并附加缝合锚钉增强进行开放或关节镜修复。平均随访41.5个月(范围33 - 50个月),所有患者术后力量和视觉模拟评分疼痛评分(范围0 - 1)均有改善,主观肩关节评分、简单肩关节测试评分以及美国肩肘外科医师评分均大于90。

结论

我们描述了在肌肉的纯肌腱部分发生的罕见肩袖撕裂,至少有1厘米的肌腱附着于完整的足迹。我们还介绍了一种关节镜侧对侧修复技术及术后结果。据我们所知,这是第一篇描述这种罕见肩袖撕裂的文章。

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