Murena L, Santovito F, de Grazia A, Libretti G, Galeazzi G, Sidoti G B, Renzi N, Trobec B, Buoite Stella A, Ramella V, Papa G, Canton G
Orthopedics and Traumatology Unit, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy.
Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy.
Musculoskelet Surg. 2025 May 8. doi: 10.1007/s12306-025-00904-x.
Mastectomy and breast reconstruction surgery are often associated with postoperative pain and functional limitation at the ipsilateral shoulder, potentially leading to scapular dyskinesis. However, few studies have determined how the type of surgery and rehabilitation might affect the development of such clinical condition.
A retrospective observational study was performed on a clinical database of females who underwent surgical and adjuvant disease control treatment against breast cancer. Data included in this analysis were: demographics and clinical history, type of surgery and duration of physiotherapy, complications, as well as scapulohumeral rhythm and shoulder soreness evaluated during the orthopedic visit.
Based on the inclusion and exclusion criteria, 67 females (age 52 y, range 30-69) entered the statistical analysis. Static dyskinesis was present in 64.2% of the sample at the time of the visit, and it was found present bilaterally in 29.9% of the sample, whereas dynamic dyskinesis was found in 73.1% of the sample at the time of the visit. Longer physiotherapy (> 20 sessions) showed a trend for a lower risk of dynamic dyskinesis (OR 0.228, 95% CI 0.046-1.114, p = 0.072), and compared to the Subpectoral Tissue Expander, Prepectoral Implant-Based Breast Reconstruction presented a reduced risk for dynamic dyskinesis (OR 0.265, 95% CI: 0.074-0.952, p = 0.042).
These preliminary findings suggest that some factors, such as the type of surgery and physiotherapy, might influence the development of scapular dyskinesis in females who undergo mastectomy and breast reconstruction.
乳房切除术和乳房重建手术常伴有同侧肩部术后疼痛和功能受限，可能导致肩胛运动障碍。然而，很少有研究确定手术类型和康复方式如何影响这种临床状况的发展。
对接受乳腺癌手术及辅助疾病控制治疗的女性临床数据库进行回顾性观察研究。该分析纳入的数据包括：人口统计学和临床病史、手术类型、物理治疗持续时间、并发症，以及骨科就诊时评估的肩肱节律和肩部酸痛情况。
根据纳入和排除标准，67名女性（年龄52岁，范围30 - 69岁）进入统计分析。就诊时，64.2%的样本存在静态运动障碍，29.9%的样本双侧存在静态运动障碍；而就诊时73.1%的样本存在动态运动障碍。较长时间的物理治疗（> 20次）显示出动态运动障碍风险较低的趋势（比值比0.228，95%置信区间0.046 - 1.114，p = 0.072），与胸大肌下组织扩张器相比，基于胸前植入物的乳房重建动态运动障碍风险降低（比值比0.265，95%置信区间：0.074 - 0.952，p = 0.042）。
这些初步研究结果表明，手术类型和物理治疗等一些因素可能会影响接受乳房切除术和乳房重建的女性肩胛运动障碍的发展。
