关节镜肩胛下肌清理术与修补术治疗Lafosse Ⅰ型肩胛下肌损伤的对比研究

Comparison of arthroscopic subscapularis repair and subscapularis debridement in treatment of Lafosse I subscapularis injury

摘要:

目的 比较关节镜肩胛下肌清理术与肩胛下肌修补术治疗Lafosse Ⅰ型肩胛下肌损伤的疗效。方法 选取2019年1月—2021年1月中国贵航集团三〇二医院收治的52例Lafosse Ⅰ型肩胛下肌损伤患者，按随机数字表法分为对照组和研究组，每组26例。对照组给予关节镜肩胛下肌清理术，研究组给予关节镜肩胛下肌修补术。术后随访12个月观察疗效。比较两组手术前后肩关节活动、疼痛、肩关节功能变化情况，记录两组手术并发症发生情况。结果 两组术前、术后12个月肩关节前屈、内旋、外旋的差值比较，差异无统计学意义（P >0.05）。两组术前、术后3个月、术后6个月、术后12个月的疼痛视觉模拟评分（VAS）比较：①不同时间点的VAS评分有差异（P <0.05）；②研究组与对照组的VAS评分无差异（P >0.05）；③研究组与对照组的VAS评分变化趋势无差异（P >0.05）。两组术前、术后12个月肩关节美国加州大学洛杉矶（UCLA）评分、简明肩关节功能测试（SST）评分、美国肩肘外科学会肩关节评分（ASES）的差值比较，差异无统计学意义（P >0.05）。两组术前、术后12个月lift-off试验、Napoleno试验、Bear Hug test试验阳性率比较，差异无统计学意义（P >0.05）。两组并发症总发生率比较，差异无统计学意义（P >0.05）。结论 关节镜肩胛下肌修补术与肩胛下肌清理术均为治疗Lafosse Ⅰ型肩胛下肌损伤的有效方法，两种手术方法均可明显提高患者肩关节活动度，减轻疼痛程度，改善肩关节功能，且安全性良好。

Abstract:

Objective To compare the effect of arthroscopic subscapularis repair and subscapularis debridement in the treatment of Lafosse I subscapularis injury.Methods A total of 52 patients with Lafosse I subscapularis injury admitted to our hospital from January 2019 to January 2021 were selected and divided into a control group and a study group by random number table method, with 26 cases in each group. The control group was given arthroscopic subscapularis debridement, and the study group was given arthroscopic subscapularis repair. The postoperative follow-up was 12 months to observe the effect. The changes in the range of motion, pain, and shoulder function of the shoulder joint before and after surgery were compared between the two groups, and the incidence of surgical complications in the two groups was recorded.Result There was no significant difference in the difference of shoulder flexion, internal rotation and external rotation between the control group and the study group before operation and 12 months after operation (P > 0.05). The comparison of the visual analogue scale (VAS) of pain between the study group and the control group before surgery, 3 months after surgery, 6 months after surgery, and 12 months after surgery showed that there were differences in the VAS scores between different time points (P < 0.05). there was no difference in the VAS score between the study group and the control group (P > 0.05), and there was no difference in the change trend of the VAS score between the study group and the control group (P > 0.05). There was no difference in the difference between the control group and the study group before and 12 months after the operation in the University of California at Los Angeles (UCLA) score, the Brief Shoulder Test (SST) score, and the American Society for Shoulder and Elbow Surgery (ASES), difference was not statistically significant (P > 0.05). There was no statistical significance in the positive values of lift-off test, Napoleno test and Bear Hug test between control group and study group before and 12 months after surgery (P > 0.05). There was no significant difference in the total incidence of complications between the control group and the study group (P > 0.05).Conclusion Both arthroscopic subscapularis repair and subscapularis debridement are effective methods for the treatment of Lafosse I subscapularis injury. Both procedures can significantly increase the range of motion of the shoulder joint, reduce pain, and improve shoulder function. And security is good.