50岁以下患者创伤性与非创伤性肩袖撕裂的特征
Characteristics of Traumatic Versus Atraumatic Rotator Cuff Tears in Patients Under 50 Years of Age.
作者信息
Chambers MaKenzie, Tornberg Haley, Curry Michael, Joshi Aditya, Koneru Manisha, Pohl Nicholas, Kleiner Matthew T, Fedorka Catherine
机构信息
Orthopaedics, Cooper Medical School of Rowan University, Camden, USA.
Neurointerventional Surgery, Cooper Medical School of Rowan University, Camden, USA.
出版信息
Cureus. 2024 Aug 8;16(8):e66450. doi: 10.7759/cureus.66450. eCollection 2024 Aug.
BACKGROUND
The prevalence of rotator cuff tears (RCTs) is known to be lower in younger patients compared to older patients. Recent studies in patients less than 50 years of age who sustain an RCT have focused on etiology, pathogenesis, and clinical outcomes following treatment. There are fewer studies that have focused on the demographics and clinical characteristics that may predispose this patient population to develop a tear. The purpose of this study is to evaluate the difference in risk factors for degenerative tears compared to traumatic tears in patients under 50 years of age.
METHODS
This single-center retrospective study utilized an internal registry of patients who had RCT injuries identified by the International Classification of Diseases (ICD)-10 code M75.1x and confirmed by MRI between 2018 and 2023. Patients 50 years of age or younger were included and then classified into traumatic versus atraumatic RCT etiology groups. Demographics, tear characteristics, and clinical comorbidities were compared between the cohorts. Statistical analyses included a two-sided student's t-test, Wilcoxon rank-sum test, Chi-square test, and Fisher's exact test.
RESULTS
A total of 177 patients under 50 years of age were identified. There was a higher prevalence of traumatic tears (59.9% vs. 40.1%; p = 0.008), the majority of whom identified as male (75.5% vs. 49.3%, p<0.001) when compared to the atraumatic cohort. Full-thickness tears were more likely to be traumatic (p = 0.04) and seen in patients insured by workers' compensation (p = 0.05). There was no significant difference in the age or preoperative comorbidities between the two groups.
CONCLUSIONS
Our study reveals a higher incidence of traumatic RCTs in a younger patient group. Sex, severity of tear, and workers' compensation were found to differ between traumatic and atraumatic cohorts. Further research is required to understand the interplay of these factors in younger patients' tear risk.
背景
已知与老年患者相比，年轻患者肩袖撕裂（RCT）的患病率较低。最近针对年龄小于50岁且发生肩袖撕裂的患者进行的研究主要集中在病因、发病机制以及治疗后的临床结果。较少有研究关注可能使该患者群体易发生撕裂的人口统计学和临床特征。本研究的目的是评估50岁以下患者中退行性撕裂与创伤性撕裂的危险因素差异。
方法
这项单中心回顾性研究利用了一个内部登记系统，该系统纳入了2018年至2023年间通过国际疾病分类（ICD）-10编码M75.1x确定并经MRI证实患有肩袖撕裂损伤的患者。纳入50岁及以下的患者，然后将其分为创伤性与非创伤性肩袖撕裂病因组。比较两组患者的人口统计学、撕裂特征和临床合并症。统计分析包括双侧学生t检验、Wilcoxon秩和检验、卡方检验和Fisher精确检验。
结果
共确定了177例50岁以下的患者。与非创伤性队列相比，创伤性撕裂的患病率更高（59.9%对40.1%；p = 0.008），其中大多数为男性（75.5%对49.3%，p<0.001）。全层撕裂更可能是创伤性的（p = 0.04），并且在获得工伤赔偿保险的患者中更为常见（p = 0.05）。两组患者的年龄或术前合并症无显著差异。
结论
我们的研究揭示了年轻患者群体中创伤性肩袖撕裂的发生率较高。发现创伤性和非创伤性队列在性别、撕裂严重程度和工伤赔偿方面存在差异。需要进一步研究以了解这些因素在年轻患者撕裂风险中的相互作用。
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