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SLAP损伤:一项回顾性多中心研究。

SLAP lesions: a retrospective multicenter study.

作者信息

Handelberg F, Willems S, Shahabpour M, Huskin J P, Kuta J

机构信息

Department of Orthopaedics and Traumatology, Academic Hospital V.U.B., Brussels, Belgium.

出版信息

Arthroscopy. 1998 Nov-Dec;14(8):856-62. doi: 10.1016/s0749-8063(98)70028-3.

Abstract

A retrospective analysis of 530 glenohumeral arthroscopies performed by three independent Belgian arthroscopists revealed the presence of 32 SLAP lesions, which represents an incidence of 6%. Since this is exactly the same percentage as found by Snyder et al., we report our data in this article. We classified 23 of the SLAP lesions using Snyder's classification, 7 needed the additional classification of Maffet et al., and 2 lesions were considered to be anatomic variations; 53% of the lesions were of type II. Concerning the mechanism of injury, we found comparable percentages of traction (22%) and compression (28%) injury as reported by Snyder, but also a high number (25%) of overhead sports activities as described by Andrews et al. Associated lesions were in close accordance with Snyder's data, but a relatively low incidence of rotator cuff injuries (10%) was present. Comparison of treatment regimens showed that the same percentage of lesions (34%) was fixed arthroscopically in both series. Only SLAP II, IV, and V lesions must be considered as unstable and in need of fixation. We confirm that patients' complaints and clinical symptoms are vague and inconsistent. Imaging, using computed tomographic arthrography or magnetic resonance, was performed in a minority of cases. Advantages and pitfalls of both techniques are discussed. Anatomic variations causing an extra-large sublabral hole are shown, and we warn about potential diagnostic and therapeutic errors in these cases.

摘要

对三位独立的比利时关节镜医师实施的530例肩关节镜检查进行回顾性分析,发现存在32例SLAP损伤,发生率为6%。由于这一百分比与斯奈德等人的研究结果完全相同,我们在本文中报告我们的数据。我们使用斯奈德分类法对23例SLAP损伤进行了分类,7例需要马费特等人的额外分类,2例损伤被认为是解剖变异;53%的损伤为II型。关于损伤机制,我们发现牵引损伤(22%)和压缩损伤(28%)的比例与斯奈德报告的相当,但也有大量(25%)如安德鲁斯等人所述的过头运动活动导致的损伤。相关损伤与斯奈德的数据密切一致,但肩袖损伤的发生率相对较低(10%)。治疗方案的比较表明,两个系列中通过关节镜固定的损伤比例相同(34%)。只有SLAP II、IV和V型损伤必须被视为不稳定且需要固定。我们证实患者的主诉和临床症状模糊且不一致。少数病例采用了计算机断层扫描关节造影或磁共振成像。讨论了这两种技术的优缺点。展示了导致超大盂唇下孔的解剖变异,并提醒注意这些病例中潜在的诊断和治疗错误。

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