Xu Guang-Jie, Dai Xue-Song
Department of Orthopaedics, the Second Affiliated Hospital of Zhejiang University Shool of Medicine, Hangzhou 310009, Zhejiang, China.
Department of Orthopaedics, the Second Affiliated Hospital of Zhejiang University Shool of Medicine, Hangzhou 310009, Zhejiang, China;
Zhongguo Gu Shang. 2018 Jul 25;31(7):612-616. doi: 10.3969/j.issn.1003-0034.2018.07.006.
To explore operative technique and clinical efficacy of tenotomy fixed on distal trochlea under arthroscopy for long head of biceps tendon and rotator cuff tear.
From June 2015 to November 2016, 23 patients with long head of biceps tendon and rotator cuff tear were treated with tenotomy fixed on distal trochlea under arthroscopy and rotator cuff repair. Among them, including 9 males and 14 females aged from 44 to 71 years old with an average of(56.38±5.74) years old, 3 patients on left shoulder injury, and the other 20 patients on right shoulder injury. Constant-Murley shoulder score, VAS score and improvement of shoulder ROM were assessed before operation, 3 months, 6 months and 12 months after operation.
All patients were followed up from 12 to 18 months with an average of (15.37±4.82) months. Ipsilateral shoulder had no obvious pain, and ROM and muscle power almost returned to the level of patients' uninjured shoulder. Postoperative Constant-Murley score at 3 months was 67.47±12.19, 74.82±13.26 at 6 months after operation and 93.47±10.19 at 12 months after operation, which were better than that of 39.62±12.39 before operation. According to Constant-Murley score, 18 patients got excellent results, 4 good and 1 poor. There was statistical significance in VAS score before operation 6.85±2.14 and 0.36±0.54 at 12 months after operation. Anteflexion of shoulder joint and abduction at 12 months after operation were (163.55±15.24)°, (164.37±14.46)°, and improved more than before operation (75.52±6.31)°, (84.36±13.36)°.
Clinical effects of tenotomy fixed on distal trochlea under arthroscopy for long head of biceps tendon and rotator cuff tear were satisfied, solving pains of shoulder joint, recovering shoulder joint functions without damaging appearance and muscle strength of musculus biceps brachii.
探讨关节镜下肱二头肌长头腱及肩袖撕裂远端滑车切断固定术的手术技巧及临床疗效。
2015年6月至2016年11月，对23例肱二头肌长头腱及肩袖撕裂患者行关节镜下远端滑车切断固定术及肩袖修补术。其中男9例，女14例，年龄44～71岁，平均（56.38±5.74）岁；左肩损伤3例，右肩损伤20例。分别于术前、术后3个月、6个月及12个月评估Constant-Murley肩关节评分、视觉模拟评分法（VAS）评分及肩关节活动度（ROM）改善情况。
所有患者均获随访，随访时间12～18个月，平均（15.37±4.82）个月。患侧肩部无明显疼痛，ROM及肌力基本恢复至健侧水平。术后3个月Constant-Murley评分为67.47±12.19，术后6个月为74.82±13.26，术后12个月为93.47±10.19，均优于术前的39.62±12.39。根据Constant-Murley评分，优18例，良4例，差1例。术前VAS评分为6.85±2.14，术后12个月为0.36±0.54，差异有统计学意义。术后12个月肩关节前屈及外展角度分别为（163.55±15.24）°、（164.37±14.46）°，较术前（75.52±6.31）°、（84.36±13.36）°明显改善。
关节镜下肱二头肌长头腱及肩袖撕裂远端滑车切断固定术临床效果满意，可解决肩关节疼痛，恢复肩关节功能，且不破坏肱二头肌外观及肌力。
