开放性肩峰成形术治疗肩峰撞击征合并肩袖损伤

目的 探讨开放性肩峰成形术治疗肩峰撞击征合并肩袖损伤的疗效.方法 2004年3月至2007年8月,对收治的20例术前明确诊断为肩峰撞击征合并肩袖损伤的患者采用开放性肩峰成形术治疗,同时修复肩袖,对肩袖全层撕裂患者以锚钉固定的方法行止点重建.术后进行系统功能康复.按照ASES评分评价功能恢复情况.结果 18例患者术后获6～13个月(平均11个月)随访.患者ASES评分术前平均为36.5分,术后为90.5分,差异有统计学意义(t=13.865,P<0.01).4例行因上肌腱直接修复患者术前ASES评分平均为53.4分,术后平均为93.2分,差异有统计学意义(t=1.387,P<0.05).14例行止点重建锚钉固定术患者术前ASES评分平均为33.4分,术后为86.2分,差异有统计学意义(t=2.962,P<0.05).结论 开放性肩峰成形术治疗肩峰撞击征合并肩袖损伤可获得满意的疗效,易于在基层医院开展.

Open acromioplasty for acromion impingement syndrome combined with rotator cuff injury

Objective To evaluate open acromioplasty for treating acromion impingement syndrome combined with rotator cuff injury. Methods From March 2004 to August 2007, 20 cases of acromion impingement syndrome combined with rotator cuff injury were treated in our department. During open acromioplasty, we repaired the rotator cuff, and reconstructed the insertion site with anchor screws for patients who had been diagnosed as complete rupture of superspinatus tendon. Postoperative rehabilitation program was conducted and all patients were followed up at our outpatient clinic. ASES (American Shoulder and Elbow Surgeons) scoring system was used to assess the outcome of the patients. Results Eighteen patients were followed up regularly for an average of 11 (6 to 13)months. The mean ASES score was 90. 5 postoperatively. A significant difference was found between the preoperative and postoperative ASES scores in this group (t= 13.865, P<0.01). Conclusion Open acromioplasty can achieve good outcome in treatment of acromion impingement syndrome combined with rotator cuff injury, and can be carried out by primary hospitals.