关节镜下Mason-Allen技术治疗肩胛下肌腱损伤

目的：评价关节镜下Mason-Allen技术修复肩胛下肌腱损伤的临床疗效和修复后肌腱结构完整性。方法：回顾性分析2015年05月至2018年12月我科关节镜下采用Mason-Allen技术修复肩胛下肌腱损伤患者的临床资料。采用视觉模拟疼痛评分（Visual Analogue Scale, VAS）、美国肩肘外科医师评分(American Shoulder and Elbow Surgeons Scale,ASES)、Constant肩关节评分对肩关节功能评估,采用术前及术后6月MRI评价肩胛下肌腱的完整性。结果：共纳入患者98例,其中男性75例,女性23例,平均年龄56.4±9.6岁;平均随访12.5±4.0个月。术前Constant肩关节评分48.3±19.0分,ASES评分43.6±15.2分,术后末次随访后分别为74.5±14.2分和78.3±17.1分;术前VAS评分3.42分,术后末次随访1.91分;术前肩关节前屈上举（87.26±16.30）°、外展外旋（52.18±11.41）°、内旋L1（T6-S3）水平,术后末次随访前屈上举（151.28±17.65）°、外展外旋（75.76±8.68）°、内旋T11（T8-S3）水平;差异均有统计学意义(P<0.05)。7例（7.1%）MRI检查存在再撕裂。结论：关节镜下应用Mason-Allen技术治疗肩胛下肌腱损伤,临床疗效改善明显,肌腱完整性良好,是关节镜下修复肩胛下肌腱的一种有效方法。     

电针与挑刺治疗肩胛下肌劳损

肩胛下肌劳损是临床常见病之一,多因外伤或疲劳过度、环境潮湿寒冷等引起发病。本病病程较长反复发作,病位较深,必须认真检查,鉴别诊断,以免误诊。确诊后采用电针挑刺拔罐进行治疗,通过对91例病人的疗效临床观察,治疗时间短,治愈率高,效果满意,值得推广。     

Narrowed coraco-humeral distance on MRI: Association with subscapularis tendon tear

Purpose

To highlight the relationship between coraco-humeral distance and subscapularis tendon tear.

喙突的形态变异与相关疾病

正肩关节韧带损伤会引起肩关节疼痛。目前很多临床医生关注肩峰形态变化对肩关节韧带的影响,而对于喙突变异所致的疾病研究较少。喙突是肩胛骨的重要组成部分,它不仅是神经血管的重要保护结构,也是多个肌腱韧带组织的附着点。喙突的解剖形态变化可导致肩关节周围一些韧带结构的损伤,这也是导致肩关节疼痛的重要原因之一。本文对喙突形态变异与相关疾病进行综述。     

The etiology and assessment of subscapularis tendon tears: a case for subcoracoid impingement, the roller-wringer effect, and tuff lesions of the subscapularis

With the advent of arthroscopy and arthroscopic repair techniques, the diagnosis and treatment of subscapularis tears have been significantly advanced. The precise etiologic factors related to subscapularis tears remain unclear. We propose that subcoracoid stenosis and subcoracoid impingement cause a “roller-wringer effect” on the subscapularis tendon. This effect increases the tensile loads on the articular surface of the subscapularis tendon that may lead to tensile undersurface fiber failure (TUFF) of the subscapularis insertion. Collectively, these factors may in part contribute to the pathogenesis of subscapularis tears.