López-Zamora I, Campos-Varela I, Luzardo-González A, Justes-Solé A
Unidad de Fisioterapia, Servicio de Medicina Física y Rehabilitación, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Unidad de Fisioterapia, Servicio de Medicina Física y Rehabilitación, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Rehabilitacion (Madr). 2023 Apr-Jun;57(2):100748. doi: 10.1016/j.rh.2022.04.003. Epub 2022 Jul 5.
Massive and irreparable lesions of the rotator cuff are frequent between people over 60 years old. Recently, inferior trapezium transference with Achilles tendon allograft has demonstrated very good results to restore shoulder's function. For this kind of surgery, it is recommended an absolute immobilization in shoulder abduction at 90° and maximal external rotation between 6-8 weeks. A 57-year-old woman underwent surgery with a lower trapezius transfer to repair the rotator cuff due to a massive and irreparable tear. She started aquatic physiotherapy 15 days after surgery and conventional physiotherapy treatment at 25 days, with a follow-up of 12 months. Good functional results of the operated shoulder were obtained, which were maintained in the postoperative follow-up. In this case early physiotherapy did not result in any risk of suture dehiscence, loosen or distressing of the allograft.
60岁以上人群中,肩袖的大面积不可修复损伤很常见。最近,异体跟腱移植下斜方肌移位术已显示出恢复肩部功能的良好效果。对于这类手术,建议在6至8周内将肩部绝对固定于外展90°并最大程度外旋位。一名57岁女性因肩袖大面积不可修复撕裂接受了下斜方肌移位修复手术。术后15天开始进行水上物理治疗,25天开始进行传统物理治疗,随访12个月。手术肩部获得了良好的功能结果,并在术后随访中得以维持。在这种情况下,早期物理治疗未导致任何缝线裂开、异体移植物松动或疼痛的风险。