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在孤立性肩胛下肌撕裂中,常规喙突成形术是否必要?

Is routine coracoplasty necessary in isolated subscapularis tears?

作者信息

Ayanoğlu Tacettin, Ataoğlu Baybars, Özer Mustafa, Çetinkaya Mehmet, Kaptan Ahmet Yiğit, Kanatlı Ulunay

机构信息

Department of Orthopaedics and Traumatology, Yozgat City Hospital, 66100 Yozgat, Turkey.

出版信息

Eklem Hastalik Cerrahisi. 2019 Aug;30(2):112-6. doi: 10.5606/ehc.2019.64710.

Abstract

OBJECTIVES

This study aims to investigate the effect of simultaneous coracoplasty on postoperative clinical outcomes of patients undergoing shoulder arthroscopy due to the tear of the isolated subscapularis.

PATIENTS AND METHODS

The study included 53 patients (16 males, 37 females; mean age 55.8 years; range, 44 to 70 years) who underwent arthroscopic repair for isolated subscapularis tear (type 2 and type 3) with anterior shoulder pain and tenderness. All patients had a coracohumeral distance of less than 7 mm on the preoperative magnetic resonance images and a minimum follow-up period of two years. Patients were divided into two groups as group 1 including patients who underwent coracoplasty and group 2 including those who did not undergo coracoplasty. Patients were evaluated pre- and postoperatively by the University of California Los Angeles (UCLA) shoulder score and the simple shoulder test (SST) score.

RESULTS

There were no significant differences between the groups in terms of age, gender and follow-up time (p>0.05). The preoperative mean UCLA score was 19.65 for group 1 and 20.45 for group 2. The postoperative mean UCLA scores were 27.92 and 29.00, respectively. The preoperative mean SST score was 4.9 for group 1 and 5.1 for group 2. The postoperative mean SST scores were 10.0 and 9.5, respectively. Functional scores increased significantly in both groups postoperatively when compared to the preoperative values (p<0.01). However, there was no statistically significant difference in terms of the increase in UCLA and SST scores between the two groups (p>0.05).

CONCLUSION

We believe that concomitant coracoplasty during arthroscopic repair may not be a necessary routine in the treatment of isolated subscapularis tears.

摘要

目的

本研究旨在探讨同期喙突成形术对因孤立性肩胛下肌撕裂而接受肩关节镜手术患者术后临床结局的影响。

患者与方法

本研究纳入了53例患者(16例男性,37例女性;平均年龄55.8岁;范围44至70岁),这些患者因孤立性肩胛下肌撕裂(2型和3型)伴肩部前方疼痛和压痛而接受关节镜修复。所有患者术前磁共振成像上的喙肱距离均小于7 mm,且最短随访期为两年。患者被分为两组,第1组包括接受喙突成形术的患者,第2组包括未接受喙突成形术的患者。通过加利福尼亚大学洛杉矶分校(UCLA)肩关节评分和简单肩关节测试(SST)评分对患者进行术前和术后评估。

结果

两组在年龄、性别和随访时间方面无显著差异(p>0.05)。第1组术前UCLA平均评分为19.65,第2组为20.45。术后UCLA平均评分分别为27.92和29.00。第1组术前SST平均评分为4.9,第2组为5.1。术后SST平均评分分别为10.0和9.5。与术前值相比,两组术后功能评分均显著提高(p<0.01)。然而,两组之间UCLA和SST评分的增加在统计学上无显著差异(p>0.05)。

结论

我们认为,在关节镜修复过程中同期进行喙突成形术可能不是治疗孤立性肩胛下肌撕裂的必要常规操作。

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