Rotator Cuff Rupture Surgery

The rotator cuff rupture surgery is used to treat rotator cuff injuries. The rotator cuff injury refers to the damage of the rotator cuff and its adjacent tissue. The rotator cuff is composed of the inner muscles of the shoulder joint, namely the superior and inferior muscles, the small round muscle and the subscapularis tendon. It is closely connected with the joint capsule and is attached to the upper end of the humerus. It is shaped like a sleeve and is called a rotator cuff. The rotator cuff injury includes partial or complete rupture of the supraspinatus muscle, large or complete avulsion of the rotator cuff, and supraspinatus tendonitis caused by trauma. Treatment of diseases: rotator cuff injury rotator cuff gap split Indication The rotator cuff rupture surgery is suitable for the diagnosis of rupture of the rotator cuff. After 4 to 6 weeks of non-surgical treatment, there is no significant effect, and the symptoms are severe. Contraindications Acromion sac bursitis combined with infection. Preoperative preparation 1. Regular X-ray examination to exclude other bone and joint lesions. 2. If necessary, perform shoulder arthrography to check whether it is connected with the acromion sac, or whether the function is improved after closure to facilitate differential diagnosis. Surgical procedure 1. Incision The shoulder is transverse to the shoulder and the inverted U-shaped incision in front of the deltoid. Starting from the posterior edge of the shoulder, it extends upward on the outside of the acromioclavicular joint, passes through the shoulder peak, and wraps around to the front side, to 3 to 5 cm below the leading edge of the shoulder. Cut the skin and subcutaneous tissue. 2, revealing the rotator cuff The deltoid muscle fibers are separated from the anterior side of the incision. At the midpoint between the acromioclavicular joint and the tip of the acromion, the shoulder is severed with a bone knife. Flip the shoulders and deltoids outwards to reveal the upper, outer and anterior sides of the deltoid sac and rotator cuff. 3. Exploring Cut the top of the sac and explore the top and bottom of the sac. If the supraspinatus tendon is completely ruptured, the rupture can be seen. If the apical surface of the supraspinatus muscle is partially broken, a superficial rupture can be seen. If the joint surface or muscle fiber is partially broken, it cannot be seen from the incision. In this case, further observation is needed: the upper arm is abducted, and the inner and outer rotations are performed, and a wrinkle may appear on the surface of the fracture; or touch with a finger At the bottom of the bursa, you can feel the unevenness of the tendon or the thinness of the rupture. 4. Repair of incomplete rupture of the supraspinatus tendon The rupture of the supraspinatus tendon is probed through the incision, and the ruptured portion is excised, and then the upper iliac crest is cut up to form a tongue-shaped tendon flap. A small bone groove is made in the bone surface of the surgical neck of the humerus near the rupture of the tendon, and two bone holes are drilled to the side of the large nodule. Through the bone hole, the lingual tendon flap was pulled down and sutured to the bone groove by the suture method, and the two sides were sutured on the subscapularis tendon and the infraspinatus tendon. 5, the repair of the complete rupture of the supraspinatus tendon The edge of the rupture is removed until the healthy tissue is revealed, so that the rupture port is V-shaped and the tip is inward. Starting from the tip of the V-shaped defect, sutured to the outside with a lace-like continuous suture until the suture tension is quite large, the suture is stopped, and a large V-shaped defect surface becomes a small defect, and the remaining defect is left. The articular cartilage is removed, thereby drilling 2 to 3 bone holes on both sides, and the two sides of the reduced V-shaped defect are fixed to the bone hole by the suture method, and the edge is in contact with the rough surface of the bone to cause it to occur. Adhesion, forming a new tendon attachment point, excision of the acromion sac and shoulder. The deltoid muscle is sewed on the periosteum and fascia on the medial segment of the acromion. If the ganglion tendon ruptures and involves the infraorbital tendon and the subscapularis tendon, the edges should be trimmed, the lateral articular surface should be cut, and a row of bone holes drilled. The rotator cuff rupture was sutured into the bone hole by horizontal suture. 6, suture incision The wound was rinsed with isotonic saline, the bleeding was completely stopped, and the incision was sutured by layer. complication 1, shoulder joint activity is limited The main complications after rotator cuff rupture repair surgery are limited shoulder movement and dysfunction, and even shoulder stiffness. It takes about 3 months after the operation, and after a functional exercise with guidance, a satisfactory function recovery can be obtained. This is difficult for middle-aged and elderly people, and it is easy to produce a "frozen shoulder" and the like, so generally has little effect on the function. Older and weaker people who are not demanding themselves may not consider surgery. 2, postoperative rotator cuff rupture It is related to factors such as improper selection of surgical repair methods, poor postoperative braking, and blind excessive functional exercise.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.