目的 探讨挤压螺钉固定和带线锚钉捆扎固定两种固定方法在关节镜下治疗肩袖损伤合并肱二头肌长头腱(LHBT)断裂的疗效。方法 选取2021年11月—2023年11月接受挤压螺钉固定治疗的75例肩袖损伤合并LHBT断裂患者作为螺钉组,选取同期接受带线锚钉捆扎固定治疗的75例肩袖损伤合并LHBT断裂患者作为锚钉组,对两组患者临床资料进行回顾性分析。结果 术前两组患者视觉模拟评分法(VAS)、美国加州大学肩关节评分系统(UCLA)评分、美国肩肘协会评分系统(ASES)评分、肩关节活动度比较,差异均无统计学意义(P>0.05);两组患者术后各时间点(3、6、12个月)VAS、UCLA、ASES评分及肩关节活动度均显著高于术前(P<0.05)。术后3个月及术后6个月,螺钉组VAS评分显著低于锚钉组(P<0.05);术后12个月,两组间VAS评分比较,差异无统计学意义(P>0.05)。术后各时间点,两组UCLA、ASES评分及肩关节活动度比较,差异均无统计学意义(P>0.05)。螺钉组并发症发生率显著高于锚钉组(P<0.05);两组再手术率比较,差异无统计学意义(P>0.05)。结论 两种固定方式均具有较好的治疗效果,挤压螺钉固定能够更好地控制术后早期患者疼痛情况,带线锚钉捆扎固定能有效降低术后并发症的发生,故临床应依据具体情况择优而选。
Objective To compare the effects of compression screw fixation versus wire-anchored strapping fixation on rotator cuff injury combined with rupture of long head biceps tendon (LHBT) under arthroscopy. Methods In this study, 75 patients with rotator cuff injury complicated with LHBT rupture who received compression screw fixation from November 2021 to November 2023 were selected as the screw group, and another 75 patients with rotator cuff injury complicated with LHBT rupture who received wire anchor binding and fixation at the same time period were selected as the anchor group. The clinical data of the two groups were retrospectively analyzed. Results There were no significant differences in visual analog scale (VAS) scores, University of California at Los Angeles Shoulder Rating Scale (UCLA) scores, American Shoulder and Elbow Surgeon’s Form (ASES) scores, and shoulder joint motion between the two groups before surgery (P>0.05). The VAS, UCLA, and ASES scores and shoulder joint motion between the two groups at all time points (3, 6, and 12 months) were significantly higher than those before surgery (P<0.05). The VAS scores of the screw group at 3 months and 6 months after surgery were significantly lower than those of the anchor group (P<0.05), and there was no significant difference in VAS score between the two groups at 12 months after surgery (P>0.05). There were no significant differences in UCLA and ASES scores and shoulder joint motion between the two groups at each time point after surgery (P>0.05). The complication rate of the screw group was significantly higher than that of the anchor group (P<0.05), and there was no significant difference in reoperation rate between the two groups (P>0.05). Conclusion Both fixation methods have good therapeutic effects. Compression screw fixation can better control the early postoperative pain of patients, and wire anchor binding and fixation can effectively reduce the occurrence of postoperative complications, so the clinical selection should be based on the specific situation.
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