Rockwood C A, Williams G R, Burkhead W Z
Department of Orthopaedics, University of Texas Health Science Center at San Antonio 78284-7774, USA.
J Bone Joint Surg Am. 1995 Jun;77(6):857-66. doi: 10.2106/00004623-199506000-00006.
A modified Neer acromioplasty, subacromial decompression, and débridement of massive, irreparable lesions of the supraspinatus and infraspinatus tendons was performed in fifty-seven patients. Fifty patients (fifty-three shoulders) were followed for an average of six and one-half years. The average age of the patients was sixty years (range, thirty-eight to seventy-four years). The results, as rated on the basis of pain, function, range of motion, strength, and satisfaction of the patient, were satisfactory in forty-four shoulders (83 per cent) and unsatisfactory in nine (17 per cent). A favorable outcome was observed in shoulders in which both the anterior portion of the deltoid muscle and the long head of the biceps tendon were intact and in which a previous acromioplasties or operations on the rotator cuff had been performed. An unsatisfactory outcome was observed in shoulders in which the anterior part of the deltoid muscle was weak or absent or in which a previous acromioplasty and attempted repair of the rotator cuff had been performed. The active forward flexion of the shoulder improved from an average of 105 degrees preoperatively to an average of 140 degrees postoperatively. The results of the present study suggest that, with proper rehabilitation, adequate decompression of the subacromial space, anterior acromioplasty, and débridement of massive tears of the rotator cuff can lead to the relief of pain and the restoration of shoulder function.
对57例患者实施了改良的Neer肩峰成形术、肩峰下减压术以及对冈上肌和冈下肌肌腱巨大、无法修复的损伤进行清创术。50例患者（53个肩部）接受了平均6.5年的随访。患者的平均年龄为60岁（范围为38至74岁）。根据疼痛、功能、活动范围、力量以及患者满意度进行评估，44个肩部（83%）的结果令人满意，9个肩部（17%）的结果不满意。在三角肌前部和肱二头肌长头均完整且之前已进行过肩峰成形术或肩袖手术的肩部观察到良好的结果。在三角肌前部薄弱或缺失或之前已进行过肩峰成形术并尝试修复肩袖的肩部观察到不满意的结果。肩部的主动前屈从术前平均105度改善至术后平均140度。本研究结果表明，通过适当的康复治疗、充分的肩峰下间隙减压、前部肩峰成形术以及对肩袖巨大撕裂进行清创术，可缓解疼痛并恢复肩部功能。
