摘要
目的:探讨关节镜下直接松解联合肩袖关节修复术治疗肩袖损伤合并继发性冻结肩患者的效果。方法:选择2021年2月至2022年4月徐州医科大学附属医院收治的经肩关节X线片、肩关节磁共振成像检查确认为肩袖损伤合并继发性冻结肩患者，排除风湿和关节炎性改变的肩关节其他疾病、骨质疏松或肌肉萎缩及合并严重心肝肾功能障碍患者。最终纳入86例患者，使用SPSS 25.0软件生成的随机数字表分为研究组和对照组，各43例。对照组采用手法松解联合肩袖关节镜修复术，研究组采用关节镜下直接松解联合肩袖关节修复术。采用t检验和卡方检验比较两组的肩关节活动情况(外展、内收、前屈、后伸度数)、肩关节功能恢复及术后并发症发生的情况。结果:与治疗前相比，两组治疗后的肩关节活动(外展、内收、前屈、后伸活动度)均明显改善，研究组优于对照组(t＝97.944、106.52、46.542、66.735、57.433、97.635、84.532、46.746、114.835、98.531、122.632、106.62，均为P<0.001)；与治疗前相比，两组治疗后的美国肩肘外科评分(ASES)评分均明显升高，研究组高于对照组(t＝121.424、132.832、83.983，均为P<0.001)；观察组术后并发症发生率低于对照组(χ2＝4.460，P<0.05)。结论:关节镜下直接松解联合肩袖修补术和手法松解术后肩袖松解术均能够改善肩袖损伤合并继发性冻结肩患者的肩关节活动度和肩袖功能，但关节镜下直接松解联合肩袖修补术在改善肩关节活动度及肩袖功能效果更好，且并发症少，有助于后期患者的康复。
Abstract
Objective:To explore the effect of direct release combined with rotator cuff joint repair under Arthroscopy in the treatment of rotator cuff injury with secondary frozen shoulder.Methods:The patients admitted to Xuzhou Medical University Affiliated Hospital from February 2021 to April 2022 were selected, who had rotator cuff injury combined with secondary frozen shoulder confirmed by shoulder X-ray and MRI. Patients with other shoulder diseases, gastric osteoporosis or muscle atrophy, and severe heart, liver, and kidney dysfunction with rheumatic and inflammatory changes were excluded. A total of 86 patients were included, and divided into the study group and the control group in a random number table generated using SPSS 25.0 software, 43 cases in each group. The control group received manual release combined with rotator cuff arthroscopic repair, while the study group received direct release combined with rotator cuff joint repair under arthroscopy. The shoulder joint activity (abduction, adduction, flexion, and extension), shoulder joint function recovery, and postoperative complications between the two groups were compared using t test and chi square test.Results:Compared with the data before treatment, the shoulder joint activity (abduction, adduction, flexion, and extension) in both groups improved significantly after treatment. The study group was better than the control group (t=97.944, 106.52, 46.542, 66.735, 57.433, 97.635, 84.532, 46.746, 114.835, 98.531, 122.632, 106.62, all P<0.001); compared with the data before treatment, American Shoulder and Elbow Surgeons (ASES) scores of both groups significantly increased after treatment, with the study group being higher than the control group (t=121.424, 132.832, 83.983, all P<0.001). The incidence of postoperative complications in the observation group was lower than that in the control group(χ2=4.460, P value<0.05).Conclusions:Both arthroscopic direct release combined with rotator cuff repair and manual release combined with postoperative rotator cuff release can improve shoulder joint range of motion and rotator cuff function in patients with rotator cuff injury and secondary frozen shoulder. However, arthroscopic direct release combined with rotator cuff repair is more effective in improving shoulder joint range of motion and rotator cuff function with fewer complications, which is helpful for the recovery of patients in the later stage.
基金项目
徐州医科大学附属医院医疗新技术项目(2023301019)
万方数据