肩袖损伤---幻灯片.pptVIP

肩袖损伤 肩袖走行及连续性 脂肪渗透（fatty infiltration） Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 1999;8:599-605. 肌肉萎缩（muscle atrophy） 1 切线征[1] （tangent sign） 2 肩胛比（scapular ratio）Scapular ratio uses the ratio of the supraspinatus muscle in cross section on the sagittal oblique image compared with the size of the supraspinatus fossa, and in supraspinatus atrophy the ratio is less than 50%[2]. 1 Zanetti M, Gerber C, Hodler J. Quantitative assessment of the muscles of the rotator cuff with magnetic resonance imaging. Invest Radiol. 1998;33:163-170. 2 Thomazeau H, Rolland Y, Lucas C, et al. Atrophy of the supraspinatus belly. Assessment by MRI in 55 patients with rotator cuff pathology. Acta Orthop Scand. 1996;67:264-268. 肩袖损伤的分类 1 全层撕裂 1）小 ＜1cm 2）中 1-3cm 3）大 3-5cm 4）巨大 ＞5cm DeOrio JK, Co?eld RH. Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg. 1984;66:563–567. 肩袖损伤的分类 2 部分撕裂 肩袖损伤的治疗 手术 VS 保守 1 年龄 Age is one of the most used parameters in decision making for the surgery of the cuff[1]. 75 years 2 撕裂大小 Shimizu[2] recommend early cuff repair after con?rming the diagnosis of massive rotator cuff tears. Partial-thickness rotator cuff tear is a further indication in those patients with minimal risk of tear extension, minimal pain, and dysfunction[3]. 1 Tanaka M, Itoi E, Sato K, et al. Factors related to successful outcome of conservative treatment for rotator cuff tears. Ups J Med Sci. 2010;115:193-200. 2 Shimizu C, Horii M, Yamashita F, et al. Prognosis of massive rotator cuff tear. Chubuseisai. 1990;33:392. 3 Ozbaydar MU, Bekmezci T, Tonbul M, et al. The results of arthroscopic repair in partial rotator cuff tears. Acta Orthop Traumatol Turc. 2006;40:49–55. 肩袖损伤的治疗 肌腱的