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创伤性肩袖撕裂的手术修复时机。

Timing of surgical repair for traumatic rotator cuff tears.

作者信息

B Pohl Nicholas, Curry Michael, Romiyo Vineeth, Wright Branden, Gentile Pietro M, Johnsen Parker, Hunter Krystal, Miller Lawrence S, Kleiner Matthew T, Pollard Mark, Fedorka Catherine J

机构信息

Cooper Medical School of Rowan University, Camden, NJ, USA.

Cooper University Health Care, Camden, NJ, USA.

出版信息

Eur J Orthop Surg Traumatol. 2025 Jun 24;35(1):272. doi: 10.1007/s00590-025-04340-2.

Abstract

PURPOSE

Traumatic full-thickness rotator cuff tears (FT-RCTs) are often treated surgically due to the acute nature of the tear. Presently, there is not a clear consensus on the appropriate timing for repair of FT-RCTs following injury. This study aims to evaluate functional outcomes based on timing of surgical repair.

METHODS

In total, 141 patients who underwent RCT repair for a tear caused by a traumatic injury from 2014 to 2021 were retrospectively reviewed. Patients were stratified based on time to surgical repair from the date of injury. Patient reported outcomes (PROMs), complication rates and range of motion (ROM) were compared. Multivariate regression was also performed using postoperative ASES as the dependent outcome.

RESULTS

Larger tears were repaired earlier, and the preoperative ROM was worse for the patients undergoing earlier repair at all time points up to three months. There were no differences in postoperative SANE score, ASES score as well as ROM or strength assessed at 12 months. Multivariate regression determined male sex (p = 0.035) and longer time to surgery (p = 0.043) were independently associated with worse postoperative ASES scores.

CONCLUSION

While there no differences in between treatment groups regarding complications and PROMs, multivariate regression demonstrated longer time to surgery following injury was associated with lower postoperative ASES scores. Similar studies have shown inconsistent outcomes following early surgical repair, utilizing varying sample populations (range = 4-358) and times to surgical intervention (range = < 3 weeks to 12 months). Multi-center collaboration is needed to better determine the impact of early surgical intervention for traumatic FT-RCTs.

摘要

目的

创伤性全层肩袖撕裂(FT-RCTs)因其撕裂的急性性质常需手术治疗。目前,对于FT-RCTs损伤后修复的合适时机尚无明确共识。本研究旨在根据手术修复时机评估功能结局。

方法

回顾性分析了2014年至2021年因创伤性损伤导致撕裂而接受RCT修复的141例患者。根据从受伤日期到手术修复的时间对患者进行分层。比较患者报告的结局(PROMs)、并发症发生率和活动范围(ROM)。还以术后ASES作为因变量进行多变量回归分析。

结果

撕裂越大修复越早,在长达三个月的所有时间点,早期修复的患者术前ROM更差。术后12个月时,SANE评分、ASES评分以及ROM或力量评估方面无差异。多变量回归分析确定男性(p = 0.035)和手术时间较长(p = 0.043)与术后ASES评分较差独立相关。

结论

虽然治疗组在并发症和PROMs方面无差异,但多变量回归分析表明,受伤后手术时间较长与术后ASES评分较低相关。类似研究表明,早期手术修复后的结局不一致,所使用的样本量不同(范围 = 4 - 358),手术干预时间也不同(范围 = < 3周至12个月)。需要多中心合作以更好地确定早期手术干预对创伤性FT-RCTs的影响。

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