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初次创伤性盂肱关节脱位后肩袖重建的功能结果和肌腱完整性。

Functional outcome and tendon integrity of rotator cuff reconstruction after primary traumatic glenohumeral dislocation.

机构信息

BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Germany.

ATOS Clinic Heidelberg, German Joint Center Heidelberg, Bismarckstr. 9-15, 69115, Heidelberg, Germany.

出版信息

Arch Orthop Trauma Surg. 2020 Aug;140(8):1073-1079. doi: 10.1007/s00402-020-03416-4. Epub 2020 Mar 31.

Abstract

INTRODUCTION

Rotator cuff tears (rct) subsequent to glenohumeral dislocation are relevant concomitant injuries, can lead to impaired shoulder function and increase risk of recurrent dislocation.

AIM

The aim of this study was to determine the functional outcome, recurrent dislocation rate and tendon integrity after rotator cuff repair after primary traumatic shoulder dislocation.

MATERIALS AND METHODS

In this retrospective case series, 23 patients (age 56.4 years ± 6.3) who underwent a rotator cuff reconstruction after primary traumatic shoulder dislocation with confirmed combination of full-thickness RCT and Bankart lesion were enrolled after a minimum follow-up of 2 years. Clinical outcome (age and gender adjusted Constant Murley Score (CMS), DASH, Rowe Score) (n = 23) and sonographic tendon integrity (n = 19) were studied.

RESULTS

After a mean follow-up of 58 ± 32 months, a CMS of 85.1% ± 14.7, DASH of 14.2 ± 20.5, and Rowe Score of 82.4 ± 15.2 indicated good functional outcome. In 4 of 19 patients (21.1%) a re-tear was found during sonographic evaluation. In 3 cases (13%), a revision was performed (2 × stiff shoulder, 1 × postoperative infection). One patient had a single traumatic re-dislocation (4.3%).

CONCLUSIONS

Patients undergone reconstruction of the rotator cuff following a primary traumatic shoulder dislocation can achieve good functional results and a low rate of recurrent dislocation. Postoperative tendon integrity is comparable with known data about non traumatic tears.

摘要

简介

肩盂肱关节脱位后继发的肩袖撕裂(rct)是相关的伴随损伤,可导致肩关节功能受损,增加复发性脱位的风险。

目的

本研究旨在确定初次创伤性肩关节脱位后修复肩袖撕裂的功能结果、复发性脱位率和肌腱完整性。

材料和方法

在这项回顾性病例系列研究中,纳入了 23 名(年龄 56.4 岁±6.3 岁)患者,这些患者在初次创伤性肩关节脱位后经历了肩袖重建,并且确认存在全层 RCT 和 Bankart 病变的组合。所有患者的随访时间均至少为 2 年。研究了临床结果(年龄和性别调整后的 Constant Murley 评分(CMS)、DASH、Rowe 评分)(n=23)和超声肌腱完整性(n=19)。

结果

在平均 58±32 个月的随访后,CMS 为 85.1%±14.7、DASH 为 14.2%±20.5、Rowe 评分为 82.4%±15.2,表明功能结果良好。在 19 名患者中的 4 名(21.1%)的超声评估中发现了再撕裂。在 3 例(13%)中进行了翻修(2 例僵硬肩,1 例术后感染)。1 名患者发生了单次创伤性再脱位(4.3%)。

结论

经历初次创伤性肩关节脱位后接受肩袖重建的患者可以获得良好的功能结果和较低的复发性脱位率。术后肌腱完整性与已知的非创伤性撕裂数据相当。

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