肩袖损伤的诊断要点与手术治疗

目的探讨肩袖损伤的临床诊断及手术治疗方法,评价手术治疗效果,验证MRI表现与术中所见的差异。方法102例肩袖损伤手术均由同一医师主刀完成,采用肩关节外侧微创切口,切除喙肩韧带,肩峰成形,探查修整肩袖,褥式缝合冈上肌、冈下肌及肩胛下肌,术后外展石膏固定。结果102例均得到半年以上随访,采用UCLA评分系统评价,优44例,良56例,差2例,术后疼痛改善率98·04%,几乎所有患者对疼痛改善满意。结论手术微创切口治疗肩袖损伤是一种行之有效的治疗方法,手术创伤小、视野良好,术后功能好,疼痛消除明显,值得临床推广运用。

Diagnosis and Surgical Treatment for Rotator Cuff Injury

Objective To explore the clinical diagnosis and surgical treatments for rotator cuff injury,and evaluate the results of surgical treatments and compare MRI features with findings in operation.Methods The operations were performed on 102 patients by a surgeon.Min incise in lateral shoulder was made.The coracoacromial lig resection,acromial arthroplasty,shoulder cuff repair,mattress suture for infraspinatus,infraspinatus and subscapularis were performed during processing with casting on abduction position after operations. Results The outcomes of surgical treatment were evaluated using scoring system of university of California,Los Angeles score (UCLA).The patients were followed up for more than half a year.Forty-four shoulders graded excellent,56 good,2 bad.Pain disappeared in 98.04% of all the 102 patients. Conclusion Minimally invasive surgery has been proved as effective surgical procedure for rotator cuff injury.This procedure with less wound and clearer sight can relieve pain and improve function of the affected shoulders significantly.