Lafosse I 肩胛下肌损伤修复在前上旋转袖损伤中没有增加额外的价值。
Repair of Lafosse I subscapularis injury adds no additional value in anterosuperior rotator cuff injury.
机构信息
Department of Osteoarthrosis, Renmin Hospital, Hubei University of Medicine, No.39 Middle Chaoyang Raod, Maojian District, Shiyan, 442000, Hubei, China.
出版信息
BMC Musculoskelet Disord. 2021 Nov 3;22(1):925. doi: 10.1186/s12891-021-04805-5.
BACKGROUND
The study aimed to explore the additional value of repair of Lafosse I subscapularis injury compared with debridement in anterosuperior rotator cuff injury.
METHODS
The prospective study was conducted on a total of 41 patients with supraspinatus tendon tear combined with Lafosse I subscapularis injury. Eighteen patients were divided into the repair group and 23 patients were divided into the non-repair group. The two groups were compared for intraoperative parameters, pain score, range of motion of the shoulder joint, shoulder joint function and quality of life (QoL) at pre-operation, 3 and 6 months postoperatively and the final follow-up visit.
RESULTS
The width of supraspinatus tendon tear did not exceed 3 cm and did not retract beyond the glenoid in among patients. There was no statistical difference of preoperative data between two groups, including age, course of disease, positive Jobe test, positive Bear-hug test, positive Lift-off test, Patte stage, longitudinal tear and pain severity (P > 0.05). Compared to preoperative levels, the severity of pain, ASES scores and EQ-5D-3L scores were significantly lower at 3 and 6 months postoperatively and the final position (P < 0.05). However, there was no statistical difference in pain severity, ASES scores and EQ-5D-3L scores between repair group and non-repair group (P > 0.05). Similarly, compared to preoperative levels, the range of motion of shoulder joint was significantly improved after operation, including internal rotation, external rotation, forward flexion and elevation (P < 0.05). However, there was no statistical difference in range of motion of shoulder joint between repair group and non-repair group (P > 0.05).
CONCLUSION
Operative treatment can effectively lessen severity of pain in the patients, improve shoulder joint function, increase the range of motion of the shoulder joint and enhance the QoL in treating anterosuperior rotator cuff injury. However, repair of subscapularis brings no benefit compared to debridement in treating supraspinatus tendon tear combined with Lafosse I subscapularis injury.
背景
本研究旨在探讨与肩袖前上部损伤清创术相比，修复 Lafosse I 肩胛下肌损伤的附加价值。
方法
前瞻性研究共纳入 41 例冈上肌腱撕裂合并 Lafosse I 肩胛下肌损伤患者。18 例患者分为修复组，23 例患者分为非修复组。比较两组患者的术中参数、疼痛评分、肩关节活动度、肩关节功能和生活质量（QoL），分别于术前、术后 3 个月和 6 个月以及最终随访时进行评估。
结果
所有患者的冈上肌腱撕裂宽度均未超过 3cm，且未超出肩胛盂。两组患者的术前数据（年龄、病程、Jobe 试验阳性、Bear-hug 试验阳性、Lift-off 试验阳性、Patte 分期、纵行撕裂和疼痛严重程度）比较，差异均无统计学意义（P>0.05）。与术前相比，两组患者术后 3 个月和最终随访时的疼痛严重程度、ASES 评分和 EQ-5D-3L 评分均明显降低（P<0.05）。然而，修复组与非修复组之间的疼痛严重程度、ASES 评分和 EQ-5D-3L 评分比较，差异均无统计学意义（P>0.05）。同样，与术前相比，两组患者术后肩关节活动度（包括内旋、外旋、前屈和上举）均明显改善（P<0.05）。然而，修复组与非修复组之间的肩关节活动度比较，差异均无统计学意义（P>0.05）。
结论
手术治疗可有效减轻肩袖前上部损伤患者的疼痛程度，改善肩关节功能，增加肩关节活动度，提高生活质量。然而，与清创术相比，修复肩胛下肌对于治疗冈上肌腱撕裂合并 Lafosse I 肩胛下肌损伤并无益处。
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