Blevins F T, Hayes W M, Warren R F
Department of Orthopaedic Surgery, Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA.
Am J Sports Med. 1996 May-Jun;24(3):263-7. doi: 10.1177/036354659602400303.
The causes and incidence of rotator cuff injuries in patients under the age of 40 has not been clearly established. The present study focuses on a group of 10 male contact athletes with rotator cuff injuries related to trauma sustained during football (ages from 24 to 36 years). Symptoms included pain and dysfunction in all 10 patients and a positive shrug sign in 8 of 10. The diagnoses for these patients were two isolated contusions, five partial-thickness tears, and three full-thickness tears. Surgery was performed on all patients after nonoperative treatment failed. Three partial-thickness tears were arthroscopically debrided. One full-thickness and two partial-thickness tears were repaired using the arthroscopically assisted miniarthrotomy technique. An open repair was performed in two patients. Two isolated rotator cuff contusions were arthroscopically debrided. The average followup was 21 months. Nine of 10 athletes returned to active participation in football, 7 of these at their preinjury levels. The diagnosis of rotator cuff injury should be considered in a contact athlete who has persistent shoulder pain, impingement signs, weakness, and a positive shrug sign. Arthroscopic debridement of the subacromial space followed by debridement or repair of rotator cuff tears, as clinically indicated, resulted in a marked improvement in function and rapid return to sport for these patients.
40岁以下患者肩袖损伤的病因及发病率尚未明确。本研究聚焦于一组10名男性接触性运动员，他们的肩袖损伤与足球运动中遭受的创伤有关（年龄在24至36岁之间）。10名患者均有疼痛和功能障碍症状，10人中有8人出现阳性耸肩征。这些患者的诊断结果为2例孤立性挫伤、5例部分厚度撕裂伤和3例全层撕裂伤。所有患者在非手术治疗失败后均接受了手术。3例部分厚度撕裂伤通过关节镜进行清创。1例全层撕裂伤和2例部分厚度撕裂伤采用关节镜辅助小切口手术技术进行修复。2例患者进行了开放修复。2例孤立性肩袖挫伤通过关节镜进行清创。平均随访时间为21个月。10名运动员中有9人恢复了积极参与足球运动，其中7人恢复到受伤前的水平。对于有持续性肩部疼痛、撞击征、无力和阳性耸肩征的接触性运动员，应考虑肩袖损伤的诊断。根据临床指征，对肩峰下间隙进行关节镜清创，随后对肩袖撕裂伤进行清创或修复，使这些患者的功能得到显著改善，并能迅速恢复运动。
