Condron Nolan B, Kaiser Joshua T, Damodar Dhanur, Wagner Kyle R, Evuarherhe Aghogho, Farley Theo, Cole Brian J
Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.
University of Massachusetts Medical School, Worcester, Massachusetts, U.S.A.
Arthrosc Sports Med Rehabil. 2022 Jan 6;4(2):e775-e788. doi: 10.1016/j.asmr.2021.11.010. eCollection 2022 Apr.
To systematically review the literature to determine the injury mechanisms, presentation, and timing of diagnosis for pediatric patients with intratendinous rotator cuff tears and to determine the efficacy of surgical intervention for affected patients.
PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus were searched. Studies were included if they involved only pediatric patients, soft-tissue rotator cuff injuries managed surgically, and reported outcomes. Patient characteristics, injury mechanisms, physical examination and imaging findings, time to diagnosis, surgical technique, and treatment outcomes were extracted. Findings were descriptively analyzed with weighted means and proportions.
Twenty-one studies comprising 78 patients were included. The age range was 8 to 17 years and 57 were male. The supraspinatus ( = 56) was the most injured tendon. American football was the most reported sport played at the time of injury. Most patients were diagnosed within 6 months of injury via magnetic resonance imaging. Arthroscopic management was undertaken in 68 patients. Forty-six of 51 patients for whom data were available returned to sports at a range of 2.5 to 12 months postoperatively. Repair failure occurred in three patients.
The extant literature regarding rotator cuff tears in pediatric patients is limited to reports of low methodological quality. Qualitative synthesis of this low-level literature reveals that rotator cuff tears are mostly reported in male collision sport athletes but may also occur in female athletes and/or throwing athletes. These injuries are often successfully managed via arthroscopic repair, and patients and their families can be reassured that the majority of patients return to sports following surgery.
Level IV, systematic review of level IV studies.
系统回顾文献，以确定小儿冈上肌腱内撕裂患者的损伤机制、临床表现及诊断时机，并确定手术干预对受影响患者的疗效。
检索了PubMed、护理及联合健康文献累积索引（CINAHL）和Scopus数据库。纳入的研究需仅涉及小儿患者、手术治疗的软组织冈上肌腱损伤并报告结局。提取患者特征、损伤机制、体格检查和影像学表现、诊断时间、手术技术及治疗结局。采用加权均值和比例对结果进行描述性分析。
纳入21项研究，共78例患者。年龄范围为8至17岁，男性57例。冈上肌（n = 56）是最常受伤的肌腱。受伤时最常报道的运动是美式橄榄球。大多数患者在受伤后6个月内通过磁共振成像确诊。68例患者接受了关节镜治疗。51例有可用数据的患者中，46例在术后2.5至12个月范围内恢复运动。3例患者修复失败。
关于小儿患者冈上肌腱撕裂的现有文献仅限于方法学质量较低的报道。对这些低质量文献的定性综合分析表明，冈上肌腱撕裂大多报道于男性碰撞运动运动员，但也可能发生在女性运动员和/或投掷运动员中。这些损伤通常通过关节镜修复成功治疗，患者及其家属可以放心，大多数患者术后可恢复运动。
IV级，IV级研究的系统评价。
