Publication: Humerus başının yukarı kayması: Rotator kılıf cerrrahisinde prognostik bir araç olarak kullanılabilir mi?
Abstract
Amaç:Rotator kılıf yırtığı bulunan hastalarda sağlam ve yırtık kılıf bulunan omuzda humerus başının glenoide göre superior’a kaymasının tamir sonrası prognostik kriter olarak kullanılabilirliği araştırıldı. Hastalar ve Yöntem:Tek taraflı tam kat rotator kılıf yırtığı tanısı konulan 27 hasta(14K,13E) çalışmaya dahil edildi.Ortalama yaş 56 (Aralık: 32-71) idi.Ameliyat öncesi her iki omuz glenohumeral eklemin AP grafileri çekildi.Humerus başının yukarı kayma miktarı(∆e) ölçüldü. Kayma miktarı 0-3 mm olan hastalar Grup A, 4-5 mm olan hastalar Grup B olarak sınıflandı.Açık rotator kılıf tamiri yapıldı.Değerlendirmede Constant skoru kullanıldı. Bulgular:Supraspinatus, infraspinatus ve subskapularis tendon yırtıkları sırasıyla 27 hastada(%100), 11 hastada(%40.7) ve 6 hastada(%22.2) vardı.19 hasta A grubunda, 8 hasta B grubundaydı. İzole supraspinatus yırtığı bulunan hastaların hepsi(n=10) ve supraspinatus, infraspinatus yırtığı bulunan 11 hastanın 9'u A grubundaydı. Supraspinatus, infraspinatus ve subskapularis yırtığı bulunan hastaların hepsi(n=6) B grubundaydı. Ortalama preoperatif Constant skoru Grup A'da 48.6, Grup B'de 21.5 olarak tespit edildi. Aradaki fark istatistiksel olarak anlamlı bulundu(p<0.001). Ortalama postoperatif Constant skoru Grup A'da 75.3 grup B'de 69 idi. Her iki grup karşılaştırıldığında aradaki fark istatistiksel olarak anlamlı bulundu.(p<0.05) Ameliyat öncesi ve sonrası Constant skorlarıyla Δe değeri arasında ters bir ilişki olduğu tespit edildi. Sonuç:Rotator kılıf yırtığından şüphelenilen hastalarda direk radyografide humerus başının yukarı kayması tamir sonrası prognozu göstermesi açısından önemlidir.
Objective:Superior excursion of the humeral head was investigated to determine whether a relationship exits between the degree of humeral head excursion and prognosis after surgical repair. Patients and Methods:Twenty-seven patients with one sided full thickness rotator cuff tears were included in this study.The mean age was 56(range:32-71) Preoperative AP x rays of both shoulders were taken. Superior excursion of the humeral head was measured.(&#8710;e) Group A includes 0-3 mm excursion, Group B 4-5 mm. All patients underwent open cuff surgery. Constant scores were used for evaluation. Results:Supraspinatus,infraspinatus and subscapularis tears were found in 27 patients(%100), 11 patients(%40.7), 6 patients(%22.2) respectively.19 patients were in Group A, 8 patients were in group B.The patients with supraspinatus tears(n=10), 9 of 11 patients with both supraspinatus and infraspinatus tears were in Group A.The patients with supraspinatus, infraspinatus and subscapularis tears (n=6) were all in Group B.The mean preoperative Constant Score was 48.6 in Group A, 21.5 in Group B.The mean postoperative Constant Score was 75.3 in Group A, 69 in Group B.There was significant difference between two groups statistically.(p<0.05)The reverse relation was found between pre/postoperative Constant scores and &#8710;e. Conclusion:Superior excursion of the humeral head is important for giving an opinion of postoperative prognosis.
Objective:Superior excursion of the humeral head was investigated to determine whether a relationship exits between the degree of humeral head excursion and prognosis after surgical repair. Patients and Methods:Twenty-seven patients with one sided full thickness rotator cuff tears were included in this study.The mean age was 56(range:32-71) Preoperative AP x rays of both shoulders were taken. Superior excursion of the humeral head was measured.(&#8710;e) Group A includes 0-3 mm excursion, Group B 4-5 mm. All patients underwent open cuff surgery. Constant scores were used for evaluation. Results:Supraspinatus,infraspinatus and subscapularis tears were found in 27 patients(%100), 11 patients(%40.7), 6 patients(%22.2) respectively.19 patients were in Group A, 8 patients were in group B.The patients with supraspinatus tears(n=10), 9 of 11 patients with both supraspinatus and infraspinatus tears were in Group A.The patients with supraspinatus, infraspinatus and subscapularis tears (n=6) were all in Group B.The mean preoperative Constant Score was 48.6 in Group A, 21.5 in Group B.The mean postoperative Constant Score was 75.3 in Group A, 69 in Group B.There was significant difference between two groups statistically.(p<0.05)The reverse relation was found between pre/postoperative Constant scores and &#8710;e. Conclusion:Superior excursion of the humeral head is important for giving an opinion of postoperative prognosis.