摘要
目的比较肩关节镜下关节囊松解联合肩峰下间隙(acromiohumeral distance,AHD)恢复治疗糖尿病继发性肩关节活动度受限与原发性冻结肩的中期临床疗效。方法回顾分析2016年1月—2021年12月行肩关节镜下270°关节囊松解联合AHD恢复治疗的22例糖尿病继发性肩关节活动度受限患者(A组)和33例原发性冻结肩患者(B组)临床资料。两组患者性别、年龄、患肩侧别、病程及术前AHD、肩关节前屈活动度、外展活动度以及美国肩肘外科协会评分(ASES)、疼痛视觉模拟评分(VAS)和Constant评分比较差异均无统计学意义(P>0.05),仅术前内旋椎体秩次和外旋活动度差异有统计学意义(P<0.05)。术前与末次随访时通过VAS评分、ASES评分和Constant评分评价患肩疼痛和功能改善程度;记录并比较肩关节主动前屈、外展、外旋活动度和内旋椎体秩次;并于X线片上测量AHD。结果两组患者均获随访,随访时间24~92个月,中位时间57个月;A、B组随访时间差异无统计学意义(P>0.05)。所有患者术中无骨折、盂唇撕裂发生,术后切口均Ⅰ期愈合,随访期间未出现切口感染、神经损伤等并发症。末次随访时,两组患者肩关节主动前屈活动度、外展活动度、外旋活动度、内旋椎体秩次及AHD、VAS评分、ASES评分、Constant评分均较术前明显改善,差异有统计学意义(P<0.05);两组间除肩关节外旋活动度变化值比较有统计学意义(P<0.05)外,其余指标比较差异均无统计学意义(P>0.05)。结论关节镜下关节囊松解联合AHD恢复术治疗糖尿病继发性肩关节活动度受限和原发性冻结肩均能取得较好的中期临床疗效,但前者的肩关节外旋改善幅度更明显。
Objective To compare the mid-term effectiveness of arthroscopic shoulder capsular release combined with acromiohumeral distance(AHD)restoration in the treatment of diabetic secondary stiff shoulder and primary frozen shoulder.Methods A retrospective analysis was conducted on clinical data of 22 patients with diabetic secondary stiff shoulder(group A)and 33 patients with primary frozen shoulder(group B),who underwent arthroscopic 270°capsular release combined with AHD restoration treatment.There was no significant difference between the two groups in gender,age,affected side,disease duration,and preoperative AHD,shoulder flexion range of motion,abduction range of motion,American Shoulder and Elbow Surgeons(ASES)score,visual analogue scale(VAS)score,and Constant score(P>0.05).Only the difference in the internal rotation cone rank and external rotation range of motion between the two groups showed significant differences(P<0.05).The improvement in shoulder pain and function was evaluated by using VAS score,ASES score,and Constant score before operation and at last follow-up.Active flexion,abduction,external rotation range of motion,and internal rotation cone rank were recorded and compared.AHD was measured on X-ray films.Results All patients were followed up 24-92 months(median,57 months).There was no significant difference in follow-up time between group A and group B(P>0.05).No fractures or glenoid labrum tears occurred during operation,all incisions healed by first intention,and no complication such as wound infection or nerve injury was observed during the follow-up.At last follow-up,there were significant improvements in active flexion,abduction,external rotation range of motion,internal rotation cone rank,AHD,VAS score,ASES score,and Constant score when compared with preoperative ones in both groups(P<0.05).Except for the difference in change in external rotation range of motion,which had significant difference between the two groups(P<0.05),there was no significant difference in other indicators between the
作者
周洲
王俊
李怀胜
杨瑷宁
唐康来
周游
周兵华
ZHOU Zhou;WANG Jun;LI Huaisheng;YANG Aining;TANG Kanglai;ZHOU You;ZHOU Binghua(Department of Orthopedics,Affiliated Renhe Hospital of China Three Gorges University,Institute of Sports Medicine of China Three Gorges University,Yichang Sports Injury and Repair Clinical Medical Research Center,Yichang Hubei,443001,P.R.China;Department of Sports Medicine Center,the First Affiliated Hospital of Army Medical University,Chongqing,400038,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2024年第7期867-873,共7页
Chinese Journal of Reparative and Reconstructive Surgery
基金
重庆市自然科学基金项目(2023NSCQ-MS-X2660)
中国人民解放军陆军高层次科技创新人才项目资助。
