Paulos L E, Meislin R J, Drawbert J
Orthopedic Specialty Hospital, Salt Lake City, Utah 84107.
Am J Sports Med. 1994 May-Jun;22(3):306-12. doi: 10.1177/036354659402200302.
A retrospective review of 42 patients in whom a rotator cuff injury was diagnosed and who subsequently underwent surgery with the superior acromion-spitting approach technique was conducted. The average size of the tear was 4.2 cm with an average tear retraction of 4.1 cm. Thirty-seven (38 shoulders) of the 42 patients underwent a physical examination, interview, and radiographs at an average followup of 33.4 months (range, 15 to 66). Using the University of California, Los Angeles Shoulder Rating Scale, 27 shoulders were graded as excellent or good, and 11 shoulders were graded as fair or poor. Radiographic examination demonstrated bony union in 29 shoulders. The remaining 9 shoulders had evidence of fibrous union that could be characterized as clinically asymptomatic. Twenty patients had computed tomography scans that demonstrated decompression where the bony or fibrous union had occurred. In addition, some increased decompression in several patients with fibrous union indicated that the anterior acromion sought its appropriate level. Based on the results of this study, the acromion-splitting approach, used as an extension of the miniapproach for rotator cuff tears, can be successfully used when a large or massive rotator cuff tear is identified.
对42例诊断为肩袖损伤并随后采用肩峰劈开入路技术进行手术的患者进行了回顾性研究。撕裂的平均大小为4.2厘米，平均撕裂回缩为4.1厘米。42例患者中的37例（38个肩部）在平均33.4个月（范围15至66个月）的随访时接受了体格检查、访谈和X光检查。使用加州大学洛杉矶分校肩评分量表，27个肩部被评为优秀或良好，11个肩部被评为一般或较差。影像学检查显示29个肩部骨愈合。其余9个肩部有纤维愈合的证据，其临床表现为无症状。20例患者进行了计算机断层扫描，显示在发生骨愈合或纤维愈合的部位有减压情况。此外，一些纤维愈合患者的减压增加表明肩峰前部找到了合适的位置。基于本研究结果，肩峰劈开入路作为肩袖撕裂微型入路的扩展，当识别出大型或巨大型肩袖撕裂时可成功应用。
