合并肩袖损伤的肩关节盂唇损伤的临床特征

目的 分析合并肩袖损伤的肩关节盂唇损伤患者的临床特征,提出其发病规律与病变特点,为临床微创手术治疗提供参考. 方法 本组50例,其中男28例,女22例;年龄30～58岁,平均45岁.记录患者的损伤机制、损伤时间、临床症状、体征,摄X线片和MRI.根据临床诊断,采用肩关节镜微创手术修复盂唇和肩袖损伤,记录损伤部位、范围及程度并进行分析.本组表现前盂唇损伤37例,上盂唇撕裂8例,后盂唇损伤5例;肩袖损伤轻度36例,中度10例,重度3例,特大裂口1例.其中肩袖前侧(冈上肌前侧)损伤21例,中部损伤(冈上肌与冈下肌部)16例,后部损伤(冈下肌部、小圆肌)13例.盂唇损伤的MRI表现为:三角外形消失,前关节囊扩大.肩袖损伤表现为:损伤部位高信号,连续性丧失. 结果 本组患者平均随访36个月(6～72个月),临床效果满意.美国加州洛杉矶大学关节功能评分标准(UCLA)评分:术前(15±3)分,术后(32±3)分(P＜0.01). 结论 创伤性肩关节盂唇损伤患者常同时合并肩袖损伤,临床上应予重视,避免遗漏诊断或耽误治疗.盂唇损伤范围与肩袖损伤部位存在对应关系,盂唇损伤范围越大,肩袖损伤越接近后侧.

Clinical characteristic of glenoid labral tears combined with rotator cuff tear

Objective To analyze the clinical characteristics of glenoid labral tear combined with rotator cuff tear so as to provide references for arthroscopic surgery.Methods A total of 50 patients (28 males and 22 females)at mean age of 45 years old(ranged from 30 to 58 years)were enrolled in the study.Clinical data including the mechanism and time of injury,symptoms,results of physical examination,X-ray and MRI were collected.Location and degree of rotator cuff and glenoid labral tears found during arthroscopic surgery were also recorded.There were 37 patients with anterior labral tears,eight with superior labrum tears and five with posterior labral tears.The rotator cuff tear was slight in 36 patients,moderate in 10 and severe in three.One patient had extra-large tear.Anterior part of rotator cuff was found torn in 21 patients,middle part in 16 and posterior part in 13.MRI of glenoid labral tears manifested disappearance of triangular appearance and enlarged joint capsule.MRI manifestations of rotator cuff tear were high signal in torn part and continuity loss.Results All patients were followed up for average 36 months(6-72 months),which showed satisfactory results.UCLA score was(15±3)points preoperatively and(32±3)points postoperatively(P＜0.01).Conclusions More attention should be paid to glenoid labral tear to avoid misdiagnosis and delayed treatment,for it is usually combined with rotator cuff tear.Location of rotator cuff tear has some relation to the range of glenoid labral tear,ie,the larger range of glenoid labral tear may induce more posterior part of rotator cuff torn.