The association of suprascapular neuropathy with massive rotator cuff tears: A preliminary report
The association of suprascapular neuropathy with massive rotator cuff tears: A preliminary report
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DOI：
10.1016/j.jse.2005.10.019
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发表时间：
2006-07-01
影响因子：
3
通讯作者：
Basamania, Carl J.
中科院分区：
文献类型：
--
作者：
Mallon, William J.;Wilson, Robert J.;Basamania, Carl J.
我们研究了8例肩袖大面积撕裂（>5 cm）患者的前瞻性连续系列研究。在最大尺寸），所有这些都与磁共振成像研究中冈上肌的严重回缩和脂肪浸润有关。所有8例患者的肌电图（EMG）结果显示棘上肌和/或冈下肌失神经支配的肩胛上神经病变。在临床上，所有患者的主动活动都受到严重限制，没有患者能够主动将患臂抬高>40度。4例患者选择了清创术和部分手术修复，采用边缘会聚原则，通过小切口入路。这些患者平均随访24个月。所有4名患者都恢复了将患臂抬高至>90度的能力，并在没有帮助的情况下将手主动置于头后。4例手术患者中有2例同意随访EMG研究，结果表明，在这两种情况下，肩胛上神经具有显著的神经再生潜力，其中1例神经几乎完全恢复。我们的结论是肩胛上神经病变可能与大量肩袖撕裂有关，部分肩袖修复术可能使神经恢复和功能改善。
We studied a prospective, consecutive series of 8 patients presenting with massive rotator cuff tears (>5 cm. in maximum dimension), all associated with severe retraction and fatty infiltration of the supraspinatus muscle on magnetic resonance imaging studies. All 8 patients had suprascopular neuropathy shown by electromyography (EMG) findings of denervation in the suprospinatus and/or infraspinatus muscles. Clinically, all patients had severe limitation of active motion, with no patient able to elevate their affected arm actively >40 degrees. Four patients elected debridement and partial surgical repair using margin convergence principles via a mini-open approach. Follow-up of these patients averaged 24 months. All 4 patients regained the ability to elevate their affected arm to >90 degrees, and to place their hand actively behind their head without assistance. Two of the 4 surgical patients consented to follow-up EMG studies that demonstrated, in both cases, that the suprascapular nerve had significant renervation potentials, with almost complete recovery of the nerve in 1 case. We conclude that suprascopular neuropathy may be associated with massive rotator cuff tears, and that partial rotator cuff repair may allow recovery of the nerve and improvement of function.