肩膀痛痛不舉怎麼辦 微創手術還你好「膀」樣
2022-05-14 記者莊兆暉/台南報導
60歲的總鋪師陳先生,多年來長期使用沉重的廚具,讓他的肩膀累積出嚴重的職業傷害,近年來得靠止痛藥度日才能強撐下去,55歲的陳女士則是左側肩膀疼痛超過半年時間,透過物理復健治療仍沒有顯著效果,疼痛難耐因此失眠;最後2人選擇到新營醫院進行微創手術,術後狀況良好,總算不用吃藥止痛,也能一夜好眠。
衛福部新營醫院骨科醫師林孝儒表示,肩膀由骨頭、肌肉、肌腱、韌帶所構成,是人體活動度最大的關節,相對地也容易受傷,而肩關節易受傷的高危險族群,一般為職業傷害(如快遞員、搬家工人)、運動員、年過40歲中年人、突然做費力的大動作者及肩膀肌肉缺乏鍛練者。
林孝儒說,最常見的肩部問題有五十肩與旋轉肌斷裂2種,五十肩正式名稱是「黏連性肩關節囊炎」,也叫做冷凝肩、冰凍肩,發生主因是肩膀關節囊組織發炎,導致肩膀疼痛、無法抬高而難以做到對側梳頭等動作;旋轉肌破裂的病人,則是因肌腱斷裂而無法自行抬高肩膀,但在別人的協助下可以把手抬高,如果沒有即時適當處理,及高機率會越趨嚴重。
林孝儒表示,這兩種狀況早期都可以選擇以復健方式治療,但如果效果不明顯,就可以考慮以外科手術處理,而傳統外科手術治療關節內損傷,通常需要破壞關節周圍的軟組織,打開關節囊後,才能加以治療,因此有術後傷口疼痛、住院天數長、復健時間長和術後疤痕緊縮及關節內的黏連,因此降低關節的活動度等後遺症。
而現在還有微創關節鏡手術可以選擇,林孝儒說,關節內視鏡手術相較與傳統手術,可以完整的視察關節狀況並處理,達到傷口小、效果佳、復原快。相較傳統手術,也可以更全面的檢查及治療問題。
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