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肩关节肩袖损伤的诊断和治疗方法

已有 4320 次阅读 2012-8-27 22:47 |个人分类:肩关节|系统分类:科研笔记| 高绪仁, 膝关节, 肩关节, 肩袖损伤, 关节镜


    美国加利福尼亚大学骨科Drew A. Lansdown医师和Brian T. Feeley医师在2012年5月份的The Physician and Sportsmedicine(医师与运动医学)杂志上撰文,回顾了肩关节肩袖损伤的诊断和治疗方法。

    在美国,肩关节肩袖损伤是非常常见的。肩关节肩袖损伤是患者来到初级保健医师处就诊的常见原因。现在看,肩关节肩袖损伤更易发生在老年人身上。肩袖的组成肌肉能够使上臂完成举过头顶的动作,并且能够控制肩关节活动。全面的体格检查能够得出肩袖损伤的诊断。影像学检查能够让我们更深刻地理解肩关节肩袖损伤的内部病理改变。核磁共振MRI检查能够让我们清晰地看到肩袖。很多肩袖撕裂,特别是部分撕裂,在保守治疗后症状能够有所缓解。对于保守治疗效果欠佳的肩关节肩袖损伤患者来说,外科手术治疗可能能够减轻患者的肩关节疼痛、提高肩关节的功能活动范围。对于肩袖不能修补的患者,可以采用反置式人工全肩关节置换术进行治疗。

    新的科技发展促使研究人员考虑在肩袖损伤治疗中采用生物学增强的办法,但这一方法还处在研究之中。

          2、Pubmed链接 http://www.ncbi.nlm.nih.gov/pubmed/22759608

 2012 May;40(2):73-86.
Evaluation and treatment of rotator cuff tears.
Source

Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA 94158, USA.

Abstract

Rotator cuff injuries are common problems and a frequent reason for patients to present to primary care physicians. These injuries are seen more frequently now with the aging population. These muscles allow for movement of the arm in overhead activities and controlled movements through space. A thorough physical examination can lead to the diagnosis of rotator cuff pathology. Radiographic imaging may offer some insight into the underlying pathology, and magnetic resonance imaging provides for excellent visualization of the rotator cuff. Many rotator cuff tears, especially partial tears, will symptomatically improve with conservative management. Surgical treatment may offer improved pain relief and function in those patients for whom nonoperative care is insufficient. In cases in which rotator cuff repair is not possible, the reverse total shoulderarthroplasty is a possibility. New technologies are also under investigation that allow for biological augmentation of rotator cuff tears.



江苏省徐州医学院附属医院骨科 
 关节镜、膝关节外科、骨科运动医学方向 高绪仁 编译

 

高绪仁:每天以解决膝、肩关节问题为乐:)

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