小切口喙突成形術治療喙突下撞擊綜合征_《中國修復重建外科雜志》

作者：

謝美明 ¹ , 唐康來 ² , 鄧銀栓 ² , 李輝 ² , 陶旭 ² , 許建中 ²

1成都軍區總醫院骨科（成都，610083）;;
2第三軍醫大學西南醫院骨科;

關鍵詞：

喙突下撞擊綜合征小切口喙突成形術肩關節功能

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的探討小切口喙突成形術治療喙突下撞擊綜合征的方法和臨床療效。方法2006年5月－2011年9月，收治喙突下撞擊綜合征患者4例。男3例，女1例；年齡20～56歲，平均36歲。病程6～22個月，平均11.2個月。先天性喙突發育異常3例，盂肱關節前方不穩1例。患者均有肩關節前方慢性疼痛和彈響史，內收、內旋和前屈時加重。Neer撞擊征試驗和Hawkins-Kennedy改良試驗呈陽性。內收軸位CT示喙肱間距變小，喙突指數增大。術中截除喙突頸0.5～1.5 cm，游離肱二頭肌短頭及喙肱肌聯合肌腱止點，重疊縫合于截骨面近端。術后支具固定肩關節6周。結果術后切口均Ⅰ期愈合，無并發癥發生。4例均獲隨訪，隨訪時間 8個月～5年。患者肩關節疼痛和彈響均消失。末次隨訪時，疼痛視覺模擬評分（VAS）、美國加州大學洛杉磯分校（UCLA）肩關節評定標準評分、Constant評分表評分及簡單肩關節測試（SST）評分平均分別為0.25、34.25、91.25、0.25分，均較術前7.75、10.25、65.50、9.75分明顯改善。內收軸位CT及三維重建和MRI顯示，過長喙突已切除，喙肱間距從術前平均4.16 mm增至13.38 mm，喙突指數從術前平均13.08 mm降至0.28 mm。結論小切口喙突成形術是治療喙突下撞擊綜合征的有效方法，具有創傷小、術后恢復良好等優點。

引用本文： 謝美明,唐康來,鄧銀栓,李輝,陶旭,許建中. 小切口喙突成形術治療喙突下撞擊綜合征. 中國修復重建外科雜志, 2012, 26(11): 1296-1299. doi: 復制

1.	Dines DM, Warren RF, Inglis AE, et al. The coracoid impingement syndrome. J Bone Joint Surg (Br), 1990, 72(2): 314-316.
2.	Kragh JF Jr, Doukas WC, Basamania CJ. Primary coracoid impingement syndrome. Am J Orthop (Belle Mead NJ), 2004, 33(5): 229-232.
3.	Lo IK, Burkhart SS. The etiology and assessment of subscapularis tendon tears: a case for subcoracoid impingement, the roller-wringer effect, and TUFF lesions of the subscapularis. Arthroscopy, 2003, 19(10): 1142-1150.
4.	Gerber C, Terrier F, Ganz R. The role of the coracoid process in the chronic impingement syndrome. J Bone Joint Surg (Br), 1985, 67(5): 703-708.
5.	Ferreira Neto AA, Almeida AM, Maiorino R, et al. An anatomical study of the subcoracoid space. Clinics (Sao Paulo), 2006, 61(5): 467-472.
6.	Giaroli EL, Major NM, Lemley DE, et al. Coracohumeral interval imaging in subcoracoid impingement syndrome on MRI. AJR Am J Roentgenol, 2006, 186(1): 242-246.
7.	Arrigoni P, Brady PC, Burkhart S. Calcific tendonitis of the subscapularis tendon causing subcoracoid stenosis and coracoid impingement. Arthroscopy, 2006, 22(10): 1139. e1-1139. e3.
8.	Franceschi F, Longo UG, Ruzzino L, et al. Arthroscopic management of calcific tendinitis of the subscapularis tendon. Knee Surg Sports Traumatol Arthrosc , 2007, 15(12): 1482-1485.
9.	Gerber C, Terrier F, Zehnder R, et al. The subcoracoid space. An anatomic study. Clin Orthop Relat Res, 1987, (215): 132-138.
10.	Tham A, Purchase R, Kelly JD 4th. The relation of the coracoid process to the glenoid: an anatomic study. Arthroscopy, 2009, 25(8): 846-848.
11.	Roche SJ, Kennedy MT, Butt AJ, et al. Coracoid impingement syndrome: a treatable cause of anterior shoulder pain. Ir J Med Sci, 2006, 175(3): 57-61.
12.	Okoro T, Reddy VR, Pimpelnarkar A. Coracoid impingement syndrome: a literature review. Curr Rev Musculoskelet Med, 2009, 2(1): 51-55.
13.	Bhatia DN, de Beer JF, du Toit DF. Coracoid process anatomy: implications in radiographic imaging and surgery. Clin Anat, 2007, 20(7): 774-784.
14.	Kleist KD, Freehill MQ, Hamilton L, et al. Computed tomography analysis of the coracoid process and anatomic structures of the shoulder after arthroscopic coracoid decompression: a cadaveric study. J Shoulder Elbow Surg, 2007, 16(2): 245-250.
15.	Garofalo R, Conti M, Massazza G, et al. Subcoracoid impingement syndrome: a painful shoulder condition related to different pathologic factors. Musculoskelet Surg, 2011, 95 Suppl 1: S25-29.

1. Dines DM, Warren RF, Inglis AE, et al. The coracoid impingement syndrome. J Bone Joint Surg (Br), 1990, 72(2): 314-316.
2. Kragh JF Jr, Doukas WC, Basamania CJ. Primary coracoid impingement syndrome. Am J Orthop (Belle Mead NJ), 2004, 33(5): 229-232.
3. Lo IK, Burkhart SS. The etiology and assessment of subscapularis tendon tears: a case for subcoracoid impingement, the roller-wringer effect, and TUFF lesions of the subscapularis. Arthroscopy, 2003, 19(10): 1142-1150.
4. Gerber C, Terrier F, Ganz R. The role of the coracoid process in the chronic impingement syndrome. J Bone Joint Surg (Br), 1985, 67(5): 703-708.
5. Ferreira Neto AA, Almeida AM, Maiorino R, et al. An anatomical study of the subcoracoid space. Clinics (Sao Paulo), 2006, 61(5): 467-472.
6. Giaroli EL, Major NM, Lemley DE, et al. Coracohumeral interval imaging in subcoracoid impingement syndrome on MRI. AJR Am J Roentgenol, 2006, 186(1): 242-246.
7. Arrigoni P, Brady PC, Burkhart S. Calcific tendonitis of the subscapularis tendon causing subcoracoid stenosis and coracoid impingement. Arthroscopy, 2006, 22(10): 1139. e1-1139. e3.
8. Franceschi F, Longo UG, Ruzzino L, et al. Arthroscopic management of calcific tendinitis of the subscapularis tendon. Knee Surg Sports Traumatol Arthrosc , 2007, 15(12): 1482-1485.
9. Gerber C, Terrier F, Zehnder R, et al. The subcoracoid space. An anatomic study. Clin Orthop Relat Res, 1987, (215): 132-138.
10. Tham A, Purchase R, Kelly JD 4th. The relation of the coracoid process to the glenoid: an anatomic study. Arthroscopy, 2009, 25(8): 846-848.
11. Roche SJ, Kennedy MT, Butt AJ, et al. Coracoid impingement syndrome: a treatable cause of anterior shoulder pain. Ir J Med Sci, 2006, 175(3): 57-61.
12. Okoro T, Reddy VR, Pimpelnarkar A. Coracoid impingement syndrome: a literature review. Curr Rev Musculoskelet Med, 2009, 2(1): 51-55.
13. Bhatia DN, de Beer JF, du Toit DF. Coracoid process anatomy: implications in radiographic imaging and surgery. Clin Anat, 2007, 20(7): 774-784.
14. Kleist KD, Freehill MQ, Hamilton L, et al. Computed tomography analysis of the coracoid process and anatomic structures of the shoulder after arthroscopic coracoid decompression: a cadaveric study. J Shoulder Elbow Surg, 2007, 16(2): 245-250.
15. Garofalo R, Conti M, Massazza G, et al. Subcoracoid impingement syndrome: a painful shoulder condition related to different pathologic factors. Musculoskelet Surg, 2011, 95 Suppl 1: S25-29.

《中國修復重建外科雜志》

小切口喙突成形術治療喙突下撞擊綜合征

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《中國修復重建外科雜志》

小切口喙突成形術治療喙突下撞擊綜合征

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料