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肩关节镜诊断肩袖断裂及McLaughlin法的

临床经验

      作者：史其林，杨明杰，周 琳，顾玉东

【摘要】  目的  探讨肩关节镜诊断肩袖断裂、McLaughlin 法的手术方法和临床经验。方法  12例肩袖断裂患者，采用全身麻醉，先以肩关节镜确诊肩袖断裂的程度和部位，再应用Neer的前肩峰成形术，将断裂后退的肩袖充分游离、缝合在肱骨大结节以近的骨槽内。术后肩外展支架固定。结果  6例术前肩外展30°，术后恢复至180°，疼痛消失，冈上冈下肌萎消失。5例术前肩外展30°，术后恢复至100°～120°，疼痛消失。1例术前肩外展30°，术后恢复至90°，冈上冈下肌萎消失。结论  术前及术中根据肩袖断裂的程度，选择合适的病例，该方法既修补了断裂的肩袖，又去除了肩峰下撞击，操作简单，安全有效。    

    【关键词】  肩袖损伤；肩峰撞击综合征；关节镜

             【Abstract】  Objective  To report the usage of arthroscope in diagnosis of rotator

cuff tear of the shoulder and the clinical experience of treatment with McLaughlin method.Methods  12 patients with rotator cuff tear， all in general anaesthesia. Firstly， find the degree and location of cuff tear with arthroscope， then perform Neer’s acromioplasty： fully dissociate the tearing cuff and fix it in the bone groove of greater tubercle of humerus and fix the shoulder with the abduction bracket.Results  All cases had 30 degree abduction preoperation. 6 cases returned to 180 degree postoperation，painless and no atrophy of supraspinatus or infraspinatus. 5 cases returned to 100-120 degree postoperation.1 case returned to 90 degree and no atrophy of supraspinatus or infraspinatus.Conclusion  This method is safe and effective. It can repair the tear cuff and heal the impingement syndrome.    

    【Key words】  rotator cuff tear；impingement syndrome；arthroscope    

    肩袖断裂是肩关节疾病中的常见病，其手术方法大致可分为：McLaughlin 法、DeBeyre法［1］、Patch法及背阔肌移位术。手术疗效各家报道均不一致，但