巨大及無法修補的旋轉肌腱斷裂之手術治療

10.6666/ClinMed.201811_82(5).0122

陳昆暉

旋轉肌腱斷裂（rotator cuff tear） ； 旋轉肌腱修補（rotator cuff repair） ； 上關節囊重建（superior capsule reconstruction） ； 肌腱轉移（tendon transfer） ； 反轉型全人工肩關節置換手術（reverse total shoulder arthroplasty）

臨床醫學月刊

82卷5期（2018 / 11 / 30）

661 - 664

繁體中文

旋轉肌（rotator cuff muscle）是肩關節活動最重要的肌肉，一般清況的斷裂都可以藉由手術達到修補的效果，但如果是非常嚴重的斷裂，就有可能無法完全修補，處理無法修補的肩旋轉肌腱斷裂對醫師來說是一個挑戰，治療方式包括關節鏡清創（debridement）或部分修補（partial repair）、肌腱轉移（tendon transfer）、上關節囊重建（superior capsule reconstruction）和反轉型人工關節置換（reverse total shoulder arthroplasty），本文將介紹這些手術方式的適應症以及臨床結果。

1. Bert, A,Neumann, W,Awiszus, F(2010).Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair.J Orthop Traumatol,11,13-20.
2. Chen, KH,Chiang, ER,Wang, HY(2017).Arthroscopic Partial Repair of Irreparable Rotator Cuff Tears: Factors Related to Greater Degree of Clinical Improvement at 2 Years of Follow-Up.Arthroscopy,33,1949-1955.
3. Gartsman, GM(1997).Massive, irreparable tears of the rotator cuff. Results of opera-tive debridement and subacromial decompression.J Bone Joint Surg Am,79,715-721.
4. Kilinc, AS,Ebrahimzadeh, MH,Lafosse, L(2009).Subacromial internal spacer for rotator cuff tendon repair: "the balloon technique".Arthroscopy,25,921-924.
5. Mihata, T,Lee, TQ,Watanabe, C(2013).Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears.Arthroscopy,29,459-470.
6. Piekaar, RSM,Bouman, ICE,van Kampen, PM(2017).Early promising outcome following arthroscopic implantation of the subacromial balloon spacer for treating massive rotator cuff tear.Musculoskelet Surg
7. Rockwood, CA, Jr,Williams, GR, Jr,Burkhead, WZ, Jr(1995).Debridement of degenerative, irreparable lesions of the rotator cuff.J Bone Joint Surg Am,77,857-866.
8. Yallapragada, RK,Apostolopoulos, A,Katsougrakis, I(2018).The use of a subacromial spacer-inspace balloon in managing patients with irreparable rotator cuff tears.J Orthop,15,862-868.