■三角肌断裂可导致肩关节功能显著丧失,在肩袖撕裂的情况下,三角肌是肩膀唯一的外展者。三角肌破裂可以继发于创伤,巨大的肩袖撕裂的结果,或术后并发症的结果。关于三角肌破裂的管理的文献很少。在这次系统审查中,我们的目标是报告三角肌破裂的发生率,手术治疗方案,以及手术治疗后的结果。
■于2023年2月1日在MEDLINE和GoogleScholar上进行了文献检索。筛选标题和摘要,并审查符合标准的文章的全文版本。纳入标准包括评估三角肌破裂手术治疗后结果的同行评审研究(直接修复,动员,重建,带蒂胸肌转移术,有或没有反向全肩关节成形术)。次要结果包括三角肌破裂的发生率和原因。
■共检索了101项研究。经过审查和参考列表中确定的其他研究,本综述共纳入14项研究.三角肌破裂的发生率从0.3%到7%不等,而且很大,发现全厚度肩袖撕裂是一个重要的危险因素.三角肌破裂的手术治疗选择包括直接修复,旋转成形术,和带蒂的肌肉肌腱转移;当指示时,这些程序可以与反向全肩关节置换配对。术后,手术肢体应固定在张力最小的位置(前屈和外展,30°-70°),持续4-8周。在这项系统评价中,大多数接受三角肌破裂手术治疗的患者在疼痛和平均术后向前抬高和外展超过90°方面有了显着改善。
■当前可用的文献表明,直接三角肌修复,旋转成形术,对于三角肌缺损和大量肩袖撕裂的患者,有或没有伴随的反向全肩关节置换术的重建(肌肉肌腱转移)是一种可接受的治疗选择。随着疼痛的改善,术后平均肩关节屈曲和外展增加。
UNASSIGNED: A deltoid rupture can result in significant losses of shoulder function, and in the setting of a rotator cuff tear, the deltoid serves as the sole abductor of the shoulder. Deltoid ruptures can be secondary to trauma, a consequence of massive rotator cuff tears, or a result of postoperative complications. There is a paucity of literature on the management of deltoid ruptures. In this systematic review, we aim to report on the incidence of deltoid ruptures, the surgical treatment options, and the outcomes following operative treatment.
UNASSIGNED: A literature search was conducted on February 1, 2023 on MEDLINE and Google Scholar. Titles and abstracts were screened and the full text versions of articles that met criteria were reviewed. Criteria for inclusion included peer-reviewed studies evaluating the outcomes following surgical treatment of deltoid ruptures (direct repair, mobilization, reconstruction, and pedicled pectoralis transfer, with or without a reverse total shoulder arthroplasty). Secondary outcomes included incidence and causes of deltoid ruptures.
UNASSIGNED: A total of 101 studies were retrieved. After review and additional studies identified from reference lists, a total of 14 studies were included in the review. The incidence of deltoid ruptures ranged from 0.3% to 7%, and large, full-thickness rotator cuff tears were found to be a significant risk factor. Surgical treatment options for deltoid ruptures include direct repair, rotationplasty, and pedicelled muscle-tendon transfers; and when indicated, these procedures can be paired with a reverse total shoulder replacement. Postoperatively, the operative extremity should be immobilized in the position of least tension (forward flexion and abduction, 30°-70°) for 4-8 weeks. Most patients in this systematic review who underwent surgical treatment of their deltoid rupture had significant improvements in pain and mean postoperative forward elevation and abduction above 90°.
UNASSIGNED: The current available literature demonstrates that direct deltoid repair, rotationplasty, or reconstruction (muscle tendon transfer) with or without a concomitant reverse total shoulder arthroplasty can be an acceptable treatment option in patients with deltoid defects and massive rotator cuff tear. The average shoulder flexion and abduction increased postoperatively with improvements in pain.