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肩胛下肌腱撕裂的开放性修复可使大多数患者的症状完全缓解,但往往无法恢复功能活动范围。

Open repair of subscapularis tendon tears leads to complete relief of symptoms in the majority of patients, but often fails to restore functional range of motion.

作者信息

Geurkink Timon H, Oudelaar Bart W, Overbeek Celeste L, Jasper Jorrit, Nelissen Rob Ghh, Nagels Jochem

机构信息

Department of Orthopaedics, Leiden University Medical Centre, Leiden, the Netherlands.

出版信息

Shoulder Elbow. 2025 Apr;17(2):166-172. doi: 10.1177/17585732241249079. Epub 2024 Apr 24.

DOI:10.1177/17585732241249079
PMID:39564565
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11571163/
Abstract

PURPOSE

To investigate the outcome of open subscapularis (SSC) repair in terms of complete relief of symptoms, regaining functional range of motion ((ROM), i.e. minimum ROM to complete all tasks of daily living) and retear rate.

METHODS

Sixty-one patients who underwent open SSC repair between 2012 and 2019 were included in a retrospective cohort study. Primary outcome measures (complete relief of symptoms, obtaining functional ROM, SSC retears), were assessed at minimum 1-year follow-up. Prognostic factors for these outcome measures were identified.

RESULTS

At final follow-up, 44 patients (72%) reported complete relief of symptoms. Pre-operatively, 23 patients (40%) had a functional ROM, which increased to 33 patients (54%) post-operatively. Eight Patients (13%) had a retear after a median follow-up of 21 months (range: 3-35). Lafosse type IV tears were associated with having persisting symptoms (OR 5, 95 confidence interval (CI) 1.2-17.9, = 0.024) and retears (OR 7, 95 CI 1.9-37.7, = 0.031).

CONCLUSION

The majority of patients reported complete relief of symptoms after SSC repair; however, only 54% obtained a functional ROM. Measuring outcome in terms of complete relief symptoms and regaining functional ROM is useful for the surgeon to evaluate the effect of surgical intervention and provides tangible information for patients.

摘要

目的

从症状完全缓解、恢复功能活动范围(即完成所有日常生活任务所需的最小活动范围)和再撕裂率方面,研究开放性肩胛下肌(SSC)修复的结果。

方法

纳入2012年至2019年间接受开放性SSC修复的61例患者进行回顾性队列研究。主要结局指标(症状完全缓解、获得功能性活动范围、SSC再撕裂)在至少1年的随访中进行评估。确定这些结局指标的预后因素。

结果

在最终随访时,44例患者(72%)报告症状完全缓解。术前,23例患者(40%)具有功能性活动范围,术后增加至33例患者(54%)。8例患者(13%)在中位随访21个月(范围:3 - 35个月)后出现再撕裂。Lafosse IV型撕裂与持续症状(比值比5,95%置信区间(CI)1.2 - 17.9,P = 0.024)和再撕裂(比值比7,95%CI 1.9 - 37.7,P = 0.031)相关。

结论

大多数患者在SSC修复后报告症状完全缓解;然而,只有54%的患者获得了功能性活动范围。以症状完全缓解和恢复功能性活动范围来衡量结局,有助于外科医生评估手术干预的效果,并为患者提供切实的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb3f/11948565/71f24439dfbe/10.1177_17585732241249079-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb3f/11948565/71f24439dfbe/10.1177_17585732241249079-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb3f/11948565/71f24439dfbe/10.1177_17585732241249079-fig1.jpg

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本文引用的文献

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Retrospective review of open and arthroscopic repair of anterosuperior rotator cuff tears with subscapularis involvement: a single surgeon's experience.回顾性分析单术者采用开放或关节镜手术治疗合并肩胛下肌损伤的肩袖前上部撕裂的临床疗效。
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