Makovskiy A A, Fedoruk G V, Stepanchenko A P, Dubrov V E
M.V.Lomonosov Moscow State University, 27 korp. 1 Lomonosovskiy pr., Moscow 119991, Russian Federation; e-mail:
A.S. Loginov Moscow Clinical Scientific Center, 86 shosse Entuziastov, Moscow 111123, Russian Fedeartion.
Adv Gerontol. 2019;32(1-2):198-202.
The aim of the study is to compare the frequency of the rotator cuff tears in patients younger and older than 60 years during shoulder dislocation. The study included the results of observation of 101 patients after shoulder dislocation without signs of damage of the rotator cuff before the trauma. All the patients were divided into 2 groups: older and younger than 60. All the patients after the injury underwent radiography and MRI. Pattern of injury of the shoulder joint was assessed via MRI. In patients younger than 60 years, the risk of a fracture of anterior margin of glenoid during the acute shoulder dislocation is higher by 5,18 times (95% CI 1,4-12,7) than in patients older than 60 years, due to direct mechanism and high-energy trauma in patients younger than 60 years. The risk of a fracture of the head of the humerus in the group of patients older than 60 years is 27,75 times higher (95% CI 3,57-215,135) than in the group of patients younger than 60, which is associated with age-related osteoporosis in the proximal humerus in patients of the older age group. In patients older than 60 years during the dislocation of the shoulder, the rotator cuff of the shoulder is damaged in 78,6% of cases, whereas in young patients it is 32,9%. The risk of rotator cuff damage in the older age group is 11,15 times (95% CI 4,047-30,734) higher than in young patients. Thus, all patients, especially those older than 60, should be undergo MRI to increase the accuracy of diagnosing of soft tissue injuries, which affects the choice of techniques and method of treatment.
本研究的目的是比较60岁及以上和60岁以下患者肩关节脱位时肩袖撕裂的发生率。该研究纳入了101例创伤前无肩袖损伤迹象的肩关节脱位患者的观察结果。所有患者分为两组：60岁及以上组和60岁以下组。所有受伤患者均接受了X线摄影和磁共振成像（MRI）检查。通过MRI评估肩关节损伤模式。60岁以下患者在急性肩关节脱位时，由于直接暴力机制和高能量创伤，肩胛盂前缘骨折的风险比60岁及以上患者高5.18倍（95%置信区间1.4 - 12.7）。60岁及以上患者组肱骨头骨折的风险比60岁以下患者组高27.75倍（95%置信区间3.57 - 215.135），这与老年患者组近端肱骨的年龄相关性骨质疏松有关。在60岁及以上患者肩关节脱位时，78.6%的病例肩袖受损，而年轻患者中这一比例为32.9%。老年组肩袖损伤的风险比年轻患者高11.15倍（95%置信区间4.047 - 30.734）。因此，所有患者，尤其是60岁及以上的患者，都应接受MRI检查，以提高软组织损伤诊断的准确性，这会影响治疗技术和方法的选择。
