肩袖损伤的教案.pptxVIP

肩袖损伤的教案第1页/共44页 肩袖损伤的流行病学Uhthoff et al.[1] found a 20% prevalence in a series of cadaver dissections in which the mean age of the donors was 59.4 years. Lehman et al.[2] found a prevalence of 17% in a large series of cadaver dissections, with a prevalence of 30% in donors older than sixty years of age. The incidence of full-thickness tears of the rotator cuffranges from 5% to 40%. Furthermore, epidemiologicalstudies show an increasing frequency of rotator cuff failure with advancing age[3].1 Uhthoff HK, Loehr J, Sarkar K. The pathogenesis of rotator cuff tears. In: Takagishi N, editor. The shoulder. Tokyo: Professional PostGraduate Services;1987: 211-2.2 Lehman C, Cuomo F, Kummer FJ, Zuckerman JD. The incidence of full thickness rotator cuff tears in a large cadaveric population. Bull Hosp Jt Dis. 1995;54(1):30-1.3 Bigliani LU, Morrison DS. Relationship between acromial morphology and rotator cuff tears. Orthop Trans. 1986;10:216.第2页/共44页 当我们在临床上遇到疑似病人，只有X片而无MRI检查时，1 我们能从X片中得到什么信息？2 我们印象中的可疑诊断有哪些？3 针对性的体查有哪些？第3页/共44页 Gazzola S, Bleakney RR.Current imaging of the rotator cuff[J].Sports Med Arthrosc,2011,19(3):300-9. cystic change of the greater tuberosity1 读X片第4页/共44页 Gazzola S, Bleakney RR.Current imaging of the rotator cuff[J].Sports Med Arthrosc,2011,19(3):300-9. normal subacromial joint space (≥7mm) (arrow)1 superior subluxation of the humeral head (arrow)2 notched humeral neck (arrowhead)第5页/共44页 Type I calci?cation with a ?uffy, ?eecy appearance with poorly de?ned borders, with acute symptoms and termed the resorptive phase. Type II calci?cation, more discreet and of homogenous density, with well-circumscribed borders, and in the formative phase.DePalma AF, Kruper JS. Long-term study of shoulder joints affliated with and treated for calci?c tendinitis[J]. Clin Orthop.1961;20:61-72.calci?c tendinopathy第6页/共44页 2 可疑诊断1 关于肩周炎 肩周炎=冻结肩（《实用骨科学》第3版），是由于肩关节周围软组织病变而引起肩关节疼痛和活动功能障碍。国外报道 Frozen shoulder 40-60 years of age, incidence 2-5%[1].3 phases[2]freezing