Gracitelli Mauro Emilio Conforto, Malavolta Eduardo Angeli, Assunção Jorge Henrique, Matsumura Bruno Akio, Kojima Kodi Edson, Ferreira Neto Arnaldo Amado
Universidade de São Paulo, Instituto de Ortopedia e Traumatologia, Grupo de Ombro e Cotovelo, São Paulo, SP, Brazil.
Rev Bras Ortop. 2017 Aug 23;52(5):601-607. doi: 10.1016/j.rboe.2016.10.016. eCollection 2017 Sep-Oct.
To evaluate supraspinatus tendon integrity with ultrasound (US) in patients submitted to proximal humeral fracture (PHF) fixation with a locking intramedullary nail.
Thirty-one patients with PHF treated with curvilinear locking intramedullary nail, aged between 50 and 85 years, were assessed by US at six months postoperatively and clinically at six and 12 months postoperatively. The primary aim was supraspinatus tendon integrity, evaluated by US at six months postoperatively. Secondary aims included the Constant-Murley, DASH score, and visual analog pain scores, as well as complications and reoperation rates.
Full-thickness rotator cuff ruptures were observed in four patients (13%), supraspinatus ruptures in three cases (10%), and subscapularis ruptures in one case (3%). Partial ruptures were diagnosed in 10 cases (32%). The results using the Constant-Murley score at 12 months were 71.3 ± 15.2 points for the entire series, with 73.2 ± 16.1 points for patients without rotator cuff ruptures and 68.7 ± 14.1 points for those with partial or complete ruptures, without a statistically significant difference ( = 0.336). Complications, exclusively for rotator cuff ruptures, were observed in nine patients (29%).
A high rate of rotator cuff ruptures was demonstrated, with partial ruptures in 32% of cases and full-thickness ruptures in 13%. However, clinical results are satisfactory, and are not influenced by the presence of rotator cuff ruptures.
采用超声（US）评估接受肱骨近端骨折（PHF）锁定髓内钉固定患者的冈上肌腱完整性。
31例接受曲线形锁定髓内钉治疗的PHF患者，年龄在50至85岁之间，术后6个月接受超声评估，术后6个月和12个月接受临床评估。主要目的是术后6个月通过超声评估冈上肌腱完整性。次要目的包括Constant-Murley评分、DASH评分、视觉模拟疼痛评分，以及并发症和再次手术率。
4例患者（13%）观察到肩袖全层撕裂，3例（10%）为冈上肌撕裂，1例（3%）为肩胛下肌撕裂。10例（32%）诊断为部分撕裂。整个系列在12个月时使用Constant-Murley评分的结果为71.3±15.2分，无肩袖撕裂的患者为73.2±16.1分，有部分或完全撕裂的患者为68.7±14.1分，无统计学显著差异（P = 0.336）。9例患者（29%）出现并发症，均为肩袖撕裂。
显示出较高的肩袖撕裂发生率，32%为部分撕裂，13%为全层撕裂。然而，临床结果令人满意，且不受肩袖撕裂的影响。
