以超音波評估肩旋轉袖破裂術後復健成效

Ultrasonographic Evaluation of Rehabilitative Outcome of Repair of Rotator Cuff Tear

林峰正(Fong-Cheng Lin) ； 張志鵬(Chih-Peng Chang) ； 陳宏庭(Hung-Ting Chen) ； 楊蕙黛(Hui-Tai Yang) ； 林慶揚(Ching-Yang Lin)

《北市醫學雜誌》 2卷9期 (2005/09) Pp. 795-802

https://doi.org/10.6200/TCMJ.2005.2.9.04

摘要

目的：因肩旋轉肌袖破裂接受手術治療患者，其術後復健成效有相當大差異。本研究藉由超音波影像的方便性，針對患者術後旋轉袖與周圍軟組織的狀態進行定期追蹤評估，期能歸納分類出復健成效與影像特徵之關聯，以作為日後復健成效評估及預測之依據。方法：收集民國92年元月至93年10月間，因旋轉袖斷裂接受手術修補且術後接受二個月以上復健之病例，研究期間約每1-2個月以超音波檢視肩關節軟組織狀態，並透過肩關節活動度與健側比較以記錄復健成效。結果：共有二十一位病例進入本研究，復健後有十人其關節活動度仍受限，復健成效好壞之超音波影像特徵最大差異在於組織層間分界消失的嚴重度。復健成效不佳者有九位(90%)分界嚴重消失，復健成效良好者則無一為重度。結論：超音波影像中組織層間分界消失現象，對於患者術後復健成效確實具有某種程度之鑑別預測之指標功效。

關鍵字

肩旋轉袖 ； 超音波 ； 組織層間分界

並列摘要

Background and Purpose: There is great variation in the rehabilitative results of shoulder rotator cuff surgical repair. This study was designed to determine whether ultrasonographic evaluation can clarify and define the variations in post-rehabilitative shoulders. Methods: Data was gathered on patients with full-thickness rotator cuff tears receiving surgical repair from January 2003 to October 2004. These patients all participated in rehabilitation programs for more than two months. During this period of rehabilitative training, sonographic examination was performed on the postoperative shoulder at intervals of one to two months. The range of motion (ROM) of the post-operative shoulder was also recorded. The study was designed to classify the sonographic characteristics of post-operative shoulders, hoping to differentiate between the sonographic appearances of shoulders with poor rehabilitative results (limited ROM) and those with good rehabilitative results (free ROM). Results: There were 21 patients enrolled. After rehabilitation, there were ten postoperative shoulders with limited ROM. The unique sonographic characteristic for these patients, different to those of post-rehabilitative shoulders with free ROM, was the severity of soft tissue plane loss surrounding the rotator cuff. Nine post-rehabilitative shoulders with limited ROM showed a severe degree of soft tissue plane loss. However, no post-rehabilitative shoulders with free ROM demonstrated a severe degree of soft tissue plane loss. Conclusions: A severe degree of soft tissue plane loss surrounding the rotator cuff interferes with the effectiveness of postoperative rehabilitation. This condition can be easily demonstrated by sonographic examination. Early and regular evaluation using sonography is valuable for adjusting the rehabilitative programs of postoperative shoulder injuries.

並列關鍵字

rotator cuff ； sonography ； soft tissue planes