PDF(Pubmed)
Abstract：
UNASSIGNED: Several classifications have been proposed for subscapularis tendon tearing (SCTs); however, there remains a poor agreement between orthopedic surgeons regarding the diagnosis and management of these lesions. Distinguishing the various tear patterns and classifying them with some prognostic significance may aid the operating surgeon in planning appropriate treatment.
UNASSIGNED: The purpose of this study was to outline the current literature regarding SCT classification and treatment and conduct a survey among shoulder and elbow surgeons to identify the approaches regarding surgical decision-making for these injuries.
UNASSIGNED: In this systematic review, we analyzed 12 articles regarding the subscapularis tendon tear classification and implications regarding treatment plans and outcomes. In addition, 4 international experts in subscapularis repair surgery participated in the development of a questionnaire form that was distributed to 1161 ASES members. One hundred sixty five surgeons participated and chose whether they agree, disagree, or abstain for each of the 32 statements in 4 parts including indications/contraindications, treatment plan, and the factors affecting outcomes in the survey.
UNASSIGNED: Classification criteria were extremely variable with differing recommendations and descriptions of tear morphology; most were based on tear size, associated shoulder pathology, or lesser tuberosity footprint exposure. Considering the multiple classification systems and the overall poor agreement regarding SCT management, our study found that the most widely agreed upon (more than 80%) statements included early surgery is advised for traumatic SCT, chronic degenerative SCT (without fatty infiltration) associated with acute supraspinatus tear is a candidate for repair, and rotator cuff arthropathy is a contraindication for SCT repair.
UNASSIGNED: Our study was able to identify both patient and tear characteristics that are well agreed upon among surgeons in the treatment of these injuries. Lafosse classification is generally widely accepted; however, it needs to be improved by some additions. Continued collaboration among surgeons is needed to establish an acceptable and broadly applicable classification system for the management of these injuries.
UNASSIGNED: The purpose of this study was to outline the current literature regarding SCT classification and treatment and conduct a survey among shoulder and elbow surgeons to identify the approaches regarding surgical decision-making for these injuries.
UNASSIGNED: In this systematic review, we analyzed 12 articles regarding the subscapularis tendon tear classification and implications regarding treatment plans and outcomes. In addition, 4 international experts in subscapularis repair surgery participated in the development of a questionnaire form that was distributed to 1161 ASES members. One hundred sixty five surgeons participated and chose whether they agree, disagree, or abstain for each of the 32 statements in 4 parts including indications/contraindications, treatment plan, and the factors affecting outcomes in the survey.
UNASSIGNED: Classification criteria were extremely variable with differing recommendations and descriptions of tear morphology; most were based on tear size, associated shoulder pathology, or lesser tuberosity footprint exposure. Considering the multiple classification systems and the overall poor agreement regarding SCT management, our study found that the most widely agreed upon (more than 80%) statements included early surgery is advised for traumatic SCT, chronic degenerative SCT (without fatty infiltration) associated with acute supraspinatus tear is a candidate for repair, and rotator cuff arthropathy is a contraindication for SCT repair.
UNASSIGNED: Our study was able to identify both patient and tear characteristics that are well agreed upon among surgeons in the treatment of these injuries. Lafosse classification is generally widely accepted; however, it needs to be improved by some additions. Continued collaboration among surgeons is needed to establish an acceptable and broadly applicable classification system for the management of these injuries.
摘要：
■对于肩胛骨下肌腱撕裂（SCT），已经提出了几种分类；然而，骨科医生在这些病变的诊断和治疗方面仍未达成一致.区分各种泪液模式并将其分类具有一定的预后意义可能有助于手术外科医生计划适当的治疗。
■本研究的目的是概述有关SCT分类和治疗的现有文献，并在肩和肘外科医生中进行调查，以确定有关这些损伤的手术决策的方法。
■在这篇系统综述中，我们分析了12篇有关肩胛骨下肌腱撕裂分类的文章,以及对治疗计划和结局的影响.此外,4名肩胛骨下修复手术的国际专家参与了问卷形式的开发，该问卷形式分发给1161名ASES成员。一百六十五名外科医生参加并选择他们是否同意，不同意,或对包括适应症/禁忌症在内的4个部分中的32个陈述中的每个陈述都弃权，治疗计划,以及影响调查结果的因素。
■分类标准变化很大，对泪液形态的建议和描述不同；大多数基于泪液大小，相关肩部病理学，或较小的结节足迹暴露。考虑到多种分类系统和关于SCT管理的总体协议较差，我们的研究发现，最广泛认同（超过80％）的陈述包括早期手术建议用于创伤性SCT，与急性冈上肌撕裂相关的慢性退行性SCT（无脂肪浸润）是修复的候选人，肩袖关节病是SCT修复的禁忌证。
我们的研究能够确定患者和泪液的特征，这些特征在外科医生的治疗中得到了很好的认同。Lafosse分类通常被广泛接受；然而，它需要通过一些补充来改进。需要外科医生之间继续合作，以建立可接受且广泛适用的分类系统来管理这些损伤。
■本研究的目的是概述有关SCT分类和治疗的现有文献，并在肩和肘外科医生中进行调查，以确定有关这些损伤的手术决策的方法。
■在这篇系统综述中，我们分析了12篇有关肩胛骨下肌腱撕裂分类的文章,以及对治疗计划和结局的影响.此外,4名肩胛骨下修复手术的国际专家参与了问卷形式的开发，该问卷形式分发给1161名ASES成员。一百六十五名外科医生参加并选择他们是否同意，不同意,或对包括适应症/禁忌症在内的4个部分中的32个陈述中的每个陈述都弃权，治疗计划,以及影响调查结果的因素。
■分类标准变化很大，对泪液形态的建议和描述不同；大多数基于泪液大小，相关肩部病理学，或较小的结节足迹暴露。考虑到多种分类系统和关于SCT管理的总体协议较差，我们的研究发现，最广泛认同（超过80％）的陈述包括早期手术建议用于创伤性SCT，与急性冈上肌撕裂相关的慢性退行性SCT（无脂肪浸润）是修复的候选人，肩袖关节病是SCT修复的禁忌证。
我们的研究能够确定患者和泪液的特征，这些特征在外科医生的治疗中得到了很好的认同。Lafosse分类通常被广泛接受；然而，它需要通过一些补充来改进。需要外科医生之间继续合作，以建立可接受且广泛适用的分类系统来管理这些损伤。
