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肩关节镜下滑膜切除术和肱二头肌长头腱切断松解术联合闭合手法松解治疗冻结肩的疗效分析

Impact of open bursectomy and biceps tendon release with closed manipulation in frozen shoulder.

机构信息

Orthopedic Department, Adana Seyhan State Hospital, Seyhan, Adana, Turkey.

Physical Therapy and Rehabilitation Department, Akdeniz Universty Medicine School, Antalya, Turkey.

出版信息

Medicine (Baltimore). 2024 Mar 15;103(11):e37499. doi: 10.1097/MD.0000000000037499.

Abstract

This retrospective observational study evaluated the efficacy of 2 different surgical approaches for the treatment of frozen shoulder (adhesive capsulitis). This study aimed to compare the efficacy, safety, and recovery times of the 2 treatment modalities. Fifty patients diagnosed with frozen shoulder and treated at Seyhan State Hospital were included in the study. The patients were retrospectively divided into 2 groups based on the treatment received. Group 1 consisted of 25 patients who underwent standard closed manipulation under anesthesia, a technique involving passive movements of the shoulder joint to tear the tight capsule and expand the range of motion (ROM). Group 2, which included 25 patients, underwent closed manipulation in addition to open bursectomy and biceps tendon capsule release. Open bursectomy involves surgical removal of the bursa to alleviate inflammation, while biceps tendon capsule release addresses chronic biceps tendonitis by partially removing the capsule of the tendon. Data on demographic information, operative details, preoperative and postoperative conditions, and patient-reported outcomes were collected and analyzed. Data analysis revealed that the combination of closed manipulation with open bursectomy and biceps tendon capsule release was more effective in reducing pain, increasing ROM, and improving quality of life than closed manipulation alone. The discussion would typically elaborate on how the results compare with existing literature, the clinical implications, and any potential limitations of the study. The results showed that the method that combined closed manipulation with open bursectomy and biceps tendon capsule release was better than closed manipulation alone in terms of reducing pain, increasing ROM, and improving quality of life.

摘要

本回顾性观察研究评估了两种不同手术方法治疗冻结肩(粘连性肩关节囊炎)的疗效。本研究旨在比较两种治疗方式的疗效、安全性和恢复时间。50 名在塞伊汉州立医院诊断为冻结肩并接受治疗的患者被纳入本研究。根据接受的治疗,患者被回顾性地分为两组。第 1 组包括 25 名接受标准闭合性麻醉下手法松解术的患者,该技术涉及被动运动肩关节以撕裂紧绷的囊和扩大活动范围(ROM)。第 2 组包括 25 名接受闭合性手法松解术的患者,此外还进行了开放性滑囊切除术和肱二头肌肌腱囊松解术。开放性滑囊切除术涉及手术切除滑囊以减轻炎症,而肱二头肌肌腱囊松解术通过部分切除肌腱囊来解决慢性肱二头肌肌腱炎。收集并分析了人口统计学信息、手术细节、术前和术后情况以及患者报告的结果数据。数据分析表明,与单纯闭合性手法松解术相比,闭合性手法松解术联合开放性滑囊切除术和肱二头肌肌腱囊松解术在减轻疼痛、增加 ROM 和改善生活质量方面更有效。讨论部分通常会详细说明结果与现有文献的比较、临床意义以及研究的任何潜在局限性。结果表明,在减轻疼痛、增加 ROM 和改善生活质量方面,联合使用闭合性手法松解术、开放性滑囊切除术和肱二头肌肌腱囊松解术的方法优于单纯闭合性手法松解术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed8/10939693/6cc7baf01a7a/medi-103-e37499-g001.jpg

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