镜下270°关节囊松解术治疗原发性冻结肩

Arthroscopic 270° capsular release for primary frozen shoulder

摘要:

[目的] 探讨镜下270°关节囊松解治疗原发性冻结肩的疗效。[方法] 回顾性分析本院2019 年1 月—2021 年7 月行关节镜下270°松解术治疗的36 例原发性冻结肩患者的临床资料，评价临床结果。[结果] 所有患者均顺利完成手术，术中未发生血管、神经损伤等并发症。患者均获得随访，随访时间平均（17.0±3.6） 个月；与术前相比，术后1、6 个月、末次随访时中国人肩关节功能评分[(35.1±2.8), (58.4±3.8), (64.2±3.7), (67.4±5.3), P＜0.001]、Constant 评分[(38.2±5.5), (59.1±4.5), (77.4±3.5), (82.8±5.4), P＜0.001]、肩前屈ROM [(64.1±8.6)°, (111.8±7.8)°, (114.8±9.5)°, (153.6±6.3)°, P＜0.001]、外展ROM [(59.3±5.3)° , (110.6±6.0)°,(144.4±6.5)°, (149.2±6.3)°, P＜0.001]、体侧外旋ROM [(13.6±4.1)°, (29.5±5.9)°, (40.1±5.3)°, (48.8±6.3)°, P＜0.001] 均显著改善（P＜0.05）。[结论] 镜下270°关节囊松解术治疗原发性冻结肩术后患者疼痛改善明显，并可有效改善肩关节活动度，临床效果满意。

Abstract:

[Objective] To investigate the clinical outcome of arthroscopic 270° capsular release in the treatment of frozen shoulder.[Methods] A retrospective study was conducted on 36 patients who received arthroscopic 270° capsular release for primary frozen shoulderin our hospital from January 2019 to July 2021. The clinical documentations were evaluated. [Results] All patients had operation performedsuccessfully, with no complications of vascular and nerve injury occurred during the operation. All patients were followed up for an averageof (17.0±3.6) months. As time elapsed from that before surgery to 1 month, 6 months postoperatively and the latest follow-up, the Chineseshoulder score [(35.1±2.8), (58.4±3.8), (64.2±3.7), (67.4±5.3), P＜0.001], Constant-Murley score [(38.2±5.5), (59.1±4.5), (77.4±3.5), (82.8±5.4), P＜0.001], forward flexion ROM [(64.1±8.6)°, (111.8±7.8)°, (114.8±9.5)°, (153.6±6.3)°, P＜0.001], abduction ROM [(59.3±5.3)°, (110.6±6.0)°, (144.4±6.5)°, (149.2±6.3)°, P＜0.001], body side external rotation ROM [(13.6±4.1)°, (29.5±5.9)°, (40.1±5.3)°, (48.8±6.3)°, P＜0.001]were significantly improved. [Conclusion] Arthroscopic 270° capsular release for the treatment of primary frozen shoulder does significant-ly relief pain, and effectively improve shoulder joint motion, with satisfactory clinical results.