Min Kyong S, Galvin Joseph, Chung Brandon, Tamate Trent, Horng Jonathan, McCadden Austin
Tripler Army Medical Center, Honolulu, HI, USA.
John A Burns School of Medicine, Honolulu, HI, USA.
JSES Rev Rep Tech. 2024 Jun 14;4(4):779-782. doi: 10.1016/j.xrrt.2024.05.009. eCollection 2024 Nov.
The partial pectoralis major transfer for the treatment of serratus anterior deficiency and modified Eden-Lange/Triple Tendon Transfer for trapezius deficiency result in improvement in pain and shoulder function. However, athletic function following these procedures is unknown. The purpose of this study is to determine the outcomes and return to military duty and athletic tasks following partial pectoralis major transfer and Tripler Tendon Transfer.
A retrospective review of prospectively gathered data was performed for all patients surgically treated for medial and lateral scapular winging at two military medical centers. Preoperative patient-reported outcomes collected included the Single Assessment Numeric Evaluation (SANE), Visual Analog Scale (VAS), and American Shoulder and Elbow Surgeons (ASES). Patients were excluded if they had less than 1 year follow-up, no postoperative patient-reported outcomes or return to military duty data.
Eleven patients were surgically treated for scapular winging, 7 patients for serratus anterior deficiency and 4 patients for trapezius deficiency and were available for follow-up at a mean of 28 months. The mean preoperative outcome scores were SANE 40.9%, VAS 4.4 and ASES 54.4. Significant improvement in SANE 77.4% ( = .001), VAS 1.8 ( = .017) and ASES 75.7 ( = .008) was identified. Five of the 9 (55.6%) active-duty service members were able to meet their fitness requirements and remain on active-duty status.
The split pectoralis major transfer for serratus anterior deficiency and the Triple Tendon Transfer for trapezius deficiency are excellent treatment options in patients who have high physical demands.
部分胸大肌转移术用于治疗前锯肌功能不全,改良伊登-兰格/三联肌腱转移术用于治疗斜方肌功能不全,可改善疼痛和肩部功能。然而,这些手术后的运动功能尚不清楚。本研究的目的是确定部分胸大肌转移术和三联肌腱转移术后的治疗效果、恢复军事任务和运动任务的情况。
对两家军事医疗中心接受手术治疗肩胛内收和外展翼状肩胛的所有患者进行前瞻性收集数据的回顾性研究。术前收集的患者报告结局包括单项评估数字评分(SANE)、视觉模拟量表(VAS)和美国肩肘外科医师协会(ASES)评分。随访时间少于1年、无术后患者报告结局或恢复军事任务数据的患者被排除。
11例患者接受了肩胛翼状畸形手术治疗,其中7例为前锯肌功能不全,4例为斜方肌功能不全,平均随访28个月。术前平均结局评分为SANE 40.9%、VAS 4.4和ASES 54.4。SANE显著改善至77.4%(P = .001),VAS改善至1.8(P = .017),ASES改善至75.7(P = .008)。9名现役军人中有5名(55.6%)能够达到体能要求并继续服现役。
对于对身体要求较高的患者,部分胸大肌转移术治疗前锯肌功能不全和三联肌腱转移术治疗斜方肌功能不全是很好的治疗选择。