疼痛弹响肩胛骨的手术方法选择
摘要
目的探讨疼痛弹响肩胛骨的手术治疗方法选择及其临床疗效。方法回顾性分析自2004-01—2016-12采用手术治疗的6例疼痛弹响肩胛骨。2例骨软骨瘤及1例血管瘤行小切口包膜外切除,并行周围肩胛胸壁间炎性滑膜切除;2例无明显增生肿块者行小切口单纯炎性滑囊切除术;1例行小切口炎性滑囊切除联合肩胛骨上内角和下角切除成形术。结果 2例骨软骨瘤与1例血管瘤患者在肩胛骨病灶切除后疼痛即刻得到缓解,术后疼痛VAS评分均降至0分,肩部弹响消失,肩关节功能Constant-Murley评分平均94分。2例小切口单纯滑囊切除者术后仍残留疼痛,术后疼痛VAS评分为5分和4分,肩胛区弹响仍存在, Constant-Murley评分为83分和79分。1例行小切口炎性滑囊切除联合肩胛骨成形术后症状完全缓解,疼痛VAS评分为0分,肩胛区弹响消失,Constant-Murley评分95分。结论小切口炎性滑囊切除联合肩胛骨上内角和下角切除成形术治疗疼痛弹响肩胛骨效果满意,可迅速缓解疼痛症状,恢复良好的肩关节功能。
引文
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[13]Warth RJ,Spiegl UJ,Millett PJ.Scapulothoracic bursitis and snapping scapula syndrome:a critical review of current evidence[J].Am J Sports Med,2015,43(1):236-245.
[14]Bhatia DN.Scapulothoracic endoscopy for the painful snapping scapula:endoscopic anatomy and scapuloplasty technique[J].Arthrosc Tech,2015,4(5):e551-e558.
[2]Menge TJ,Horan MP,Tahal DS,et al.Arthroscopic treatment of snapping scapula syndrome:outcomes at minimum of 2 Years[J].Arthroscopy,2017,33(4):726-732.
[3]Morita W,Nozaki T,Tasaki A.MRI for the diagnosis of scapular dyskinesis:a report of two cases[J].Skeletal Radiol,2017,46(2):249-252.
[4]Conduah AH,Baker CR 3rd,Baker CJ Jr.Clinical management of scapulothoracic bursitis and the snapping scapula[J].Sports Health,2010,2(2):147-155.
[5]Manske RC,Reiman MP,Stovak ML.Nonoperative and operative management of snapping scapula[J].Am J Sports Med,2004,32(6):1554-1565.
[6]Totlis T,Konstantinidis GA,Karanassos MT,et al.Bony structures related to snapping scapula:correlation to gender,side and age[J].Surg Radiol Anat,2014,36(1):3-9.
[7]Wang ML,Miller AJ,Ballard BL,et al.Management of snapping scapula syndrome[J].Orthopedics,2016,39(4):e783-e786.
[8]Millett PJ,Gaskill TR,Horan MP,et al.Technique and outcomes of arthroscopic scapulothoracic bursectomy and partial scapulectomy[J].Arthroscopy,2012,28(12):1776-1783.
[9]Harper GD,Mcllroy S,Bayley JI,et al.Arthroscopic partial resection of the scapula for snapping scapula:a new technique[J].J Shoulder Elbow Surg,1999,8(1):53-57.
[10]Spiegl UJ,Petri M,Smith SW,et al.Association between scapula bony morphology and snapping scapula syndrome[J].J Shoulder Elbow Surg,2015,24(8):1289-1295.
[11]Vastamaki M,Vastamaki H.Open surgical treatment for snapping scapula provides durable pain relief,but so does nonsurgical treatment[J].Clin Orthop Relat Res,2016,474(3):799-805.
[12]Saper M,Kasik C,Dietzel D.Arthroscopic scapulothoracic decompression for snapping scapula syndrome[J].Arthrosc Tech,2015,4(6):e631-e636.
[13]Warth RJ,Spiegl UJ,Millett PJ.Scapulothoracic bursitis and snapping scapula syndrome:a critical review of current evidence[J].Am J Sports Med,2015,43(1):236-245.
[14]Bhatia DN.Scapulothoracic endoscopy for the painful snapping scapula:endoscopic anatomy and scapuloplasty technique[J].Arthrosc Tech,2015,4(5):e551-e558.