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肩袖撕裂治疗的叙述性综述:手术与保守治疗

A Narrative Review of Rotator Cuff Tear Management: Surgery Versus Conservative Treatment.

作者信息

Altamimi Turki Abdulaziz, Alkathami Abdulaziz Ahmed, Al-Awn Raghad Mahdi M, Alkhaldi Mohammed Hamoud Eid, Alhudaithi Muath Hussain M, Alqahtani Abdulhadi Ali, Alzahrani Afaf Abdulaziz Salem, Aladwani Sally Saleh Mohammed, Abdulrahman Aljalal Fahad, Almutawah Ahmed Nasser A

机构信息

Orthopedics, King Fahad Medical City, Riyadh, SAU.

Orthopedics, Imam Muhammad Ibn Saud Islamic University, Riyadh, SAU.

出版信息

Cureus. 2024 Dec 2;16(12):e74988. doi: 10.7759/cureus.74988. eCollection 2024 Dec.

Abstract

Rotator cuff tears are a prevalent musculoskeletal issue, particularly among middle-aged and elderly individuals, affecting shoulder stability and arm movement. These tears can arise from acute injuries or chronic wear and tear, leading to conditions ranging from tendinopathy to cuff tear arthropathy. The prevalence increases with age, with a significant portion of older adults affected, many of whom may be asymptomatic. This highlights the necessity for effective management strategies to improve patients' quality of life. The objective of this literature review is to evaluate the evidence on treatment options for rotator cuff injuries, particularly comparing the long-term results of surgical versus non-surgical interventions. While surgical treatments generally provide better functional outcomes and pain relief, non-surgical options like physical therapy and corticosteroid injections can also be effective, especially for smaller tears. The choice of treatment depends on factors like the size of the tear, patient's age, activity level, and overall health. The review highlights the importance of personalized treatment approaches that consider both clinical and economic factors. Although surgical treatments may incur higher initial costs, they often offer superior long-term benefits, especially for younger patients or those with significant tears.

摘要

肩袖撕裂是一种常见的肌肉骨骼问题,在中年和老年人中尤为普遍,会影响肩部稳定性和手臂活动。这些撕裂可能由急性损伤或慢性磨损引起,导致从肌腱病到肩袖撕裂性关节病等一系列病症。患病率随年龄增长而增加,很大一部分老年人受到影响,其中许多人可能没有症状。这凸显了采取有效管理策略以改善患者生活质量的必要性。这篇文献综述的目的是评估肩袖损伤治疗选择的证据,特别是比较手术与非手术干预的长期结果。虽然手术治疗通常能提供更好的功能结果和疼痛缓解,但物理治疗和皮质类固醇注射等非手术选择也可能有效,尤其是对于较小的撕裂。治疗选择取决于撕裂大小、患者年龄、活动水平和整体健康等因素。该综述强调了考虑临床和经济因素的个性化治疗方法的重要性。虽然手术治疗可能会产生更高的初始成本,但它们通常能提供更好的长期益处,特别是对于年轻患者或撕裂严重的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7196/11692865/25576f0f7602/cureus-0016-00000074988-i01.jpg

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