Zafra Manuel, Uceda Pilar, Muñoz Francisco, Ruiz-Bonilla Carmen, Font Pilar
Instituto de Traumatología, Hospital Quirón, Córdoba, Spain.
Reina Sofía University Hospital, Córdoba, Spain.
Shoulder Elbow. 2021 Jun;13(3):260-267. doi: 10.1177/1758573219884048. Epub 2019 Nov 4.
The purpose of this study was to prospectively compare clinical outcomes of reverse total shoulder arthroplasty (RTSA) combined with latissimus dorsi transfer by modified L'Episcopo (Group I) versus the greater tuberosity (Group II) in patients with lack of elevation and external rotation in the shoulder.
Eighteen patients participated in the study. They were placed randomly into two groups of nine patients in each group. The results were evaluated prior to surgery and at the end follow-up.
The average follow-up was 33.2 months. The mean ASES scores improved from 13 points to 79 in Group I and from 15 to 73 in Group II. The mean Constant shoulder scores improved from 19 to 66 in Group I and from 18 to 67 in Group II. Mean active elevation increased from 59° to 147° in Group I and from 58° to 148° in Group II. The mean external rotation scores increased from -43° to 7° in Group I and from -41° to 23° in Group II.
Comparing clinical outcomes and active elevation, there were no significant differences. The latissimus dorsi transfer to the greater tuberosity provided greater external rotation than did the modified L'Episcopo transfer.
本研究的目的是前瞻性比较改良L'Episcopo法背阔肌转移联合反式全肩关节置换术（RTSA）（I组）与大结节转移（II组）在肩部缺乏上举和外旋功能患者中的临床疗效。
18例患者参与本研究。他们被随机分为两组，每组9例。在手术前和随访结束时对结果进行评估。
平均随访33.2个月。I组ASES平均评分从13分提高到79分，II组从15分提高到73分。I组Constant肩关节平均评分从19分提高到66分，II组从18分提高到67分。I组平均主动上举从59°增加到147°，II组从58°增加到148°。I组平均外旋评分从-43°增加到7°，II组从-41°增加到23°。
比较临床疗效和主动上举情况，两组无显著差异。背阔肌转移至大结节比改良L'Episcopo转移提供了更大的外旋角度。
