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中华肩肘外科电子杂志

中华肩肘外科电子杂志 ›› 2022, Vol. 10 ›› Issue (01) : 82 -87. doi: 10.3877/cma.j.issn.2095-5790.2022.01.015

综述

肩袖分层撕裂的治疗策略
陈乐1, 黄志宇1, 滕强1, 侯辉歌1, 李劼若1, 王华军1, 郑小飞1,†()   
  1. 1. 510000　广州，暨南大学附属第一医院骨关节与运动医学科
  • 收稿日期:2021-06-03 出版日期:2022-02-05
  • 通信作者: 郑小飞
  • 基金资助:
    国家自然科学基金项目(81973660)

The therapy strategy of delaminated rotator cuff tears

Le Chen1, Zhiyu Huang1, Qiang Teng1   

  • Received:2021-06-03 Published:2022-02-05
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引用本文：

陈乐, 黄志宇, 滕强, 侯辉歌, 李劼若, 王华军, 郑小飞. 肩袖分层撕裂的治疗策略[J]. 中华肩肘外科电子杂志, 2022, 10(01): 82-87.

Le Chen, Zhiyu Huang, Qiang Teng. The therapy strategy of delaminated rotator cuff tears[J]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2022, 10(01): 82-87.

图1 分层撕裂6种类型的冠状位示意图[11]　图A:Type1A;图B：Type1B；图C：Type1C；图D：Type2A；图E：Type2B；图F：Type2C
图2 撕裂大小示意图[12]
图3 分层撕裂肩袖的组织学研究[8]　图A：分层撕裂肩袖的边缘处滑膜样细胞；图B：撕裂肩袖表面的滑膜样细胞
图4 保留关节侧的全层缝合方法　图A：关节侧"小窗"以便过线；图B：操作示意图；图C-D：镜下观[33]
图5 不同于传统的双排缝合桥修复方式　图A:操作示意图：（1）为置入内排，缝线两端均穿过两层，（2）为置入lamina-specific锚钉，缝线一端仅穿过深层，（3）为外排锚钉，缝线穿过浅层，（4）为打结固定；图B：不同缝线穿肌腱的方式：内排锚钉缝线穿过两层，lamina-specific锚钉缝线仅穿过深层；图C：深侧固定在足印区；图D：完成修复注：红圈表示内排锚钉缝线；黄圈表示lamina-specific锚钉缝线；IL为深层；SL为浅层[38]
图6 lasso loop缝合法示意图（右肩，后面观）　图A：大结节置入内排锚钉；图B：lasso loop穿过深层后再穿过浅层腱腹连接处；图C：缝线另一端穿过浅层；图D：拉紧穿过一端缝线后深层会靠向lasso loop端；图E：缝线打结；图F：1~2个无结锚钉缝合桥技术固定，完成双排修复[39]注：*为浅层；∨为深层；LL为lasso loop
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