【摘要】 目的 探讨关节镜改良Mason-Allen缝合技术治疗老年患者肩胛下肌Lafosse Ⅱ型撕裂早期治疗效果。方法 回顾性分析肩关节镜下改良Mason-Allen缝合技术治疗老年患者肩胛下肌LafosseⅡ型损伤57例患者的临床资料。比较术前术后末次随访时疼痛视觉模拟评分（VAS）、美国肩肘外科协会（ASES）评分、肩关节功能改良（Constant-Murley）评分、加利福尼亚大学洛杉矶（UCLA）肩部评分。患者术后1年随访时采用肩关节磁共振成像（MPI）检查评估分析肩胛下肌腱完整性。结果 所有患者术后切口均Ⅰ期愈合，均无感染，无神经血管损伤、锚钉拔出、肩胛下肌腱再撕裂等情况发生。所有患者随访12～19个月，平均为（15.0±3.4）个月，末次随访UCLA评分、ASES评分、Constant-Murley评分、VAS评分和肩关节活动度均明显改善，与术前比较差异有统计学意义（P<0.05）；术后1年MRI显示肩胛下肌愈合，未发现再次撕裂，无锚钉拔出。结论 关节镜改良Mason-Allen缝合技术治疗老年患者肩胛下肌LafosseⅡ型撕裂早期疗效改善明显，肌腱完整性良好，值得临床推广。更多还原

【Abstract】 Objective To explore the early therapeutic effect of modified Mason-Allen suture technique under arthroscopy in the treatment of LafosseII tear of the subscapular muscle in elderly patients.Methods A retrospective analysis was conducted on the clinical data of 57 elderly patients with Lafosse type Ⅱ injury of the subscapular muscle treated by modified Mason-Allen suture technique under shoulder arthroscopy.The visual analogue scale(VAS)for pain,the American society of shoulder and elbow surgeons(ASES)score,the CONSTANT-MURLEY score for modified shoulder function,and the University of California,Los Angeles(UCLA)shoulder score were compared at the last follow-up before and after the operation.The integrity of the subscapular tendon was evaluated and analyzed by shoulder joint magnetic resonance imaging(MRI)during the 1-year follow-up of the patients after the operation.Results All patients had primary healing of incisions without infection,neurovascular injury,anchor pullout,or re-tearing of the subscapularis tendon.All patients were followed up for 12 to 19 months,with an average of(15.0±3.4)months.At the last follow-up,the UCLA score,ASES score,Constant-Murley score,VAS score and shoulder joint range of motion were significantly improved,and the differences were statistically significant compared with those before the operation(P<0.05).One year after the operation,MRI showed that the subscapular muscle had healed without re-tearing and anchor pullout.Conclusion The modified Mason-Allen suture technique under arthroscopy has significantly improvement in the treatment of Lafosse type Ⅱ tear of the subscapular muscle in elderly patients,and the tendon integrity is good.It is worthy of clinical promotion.更多还原