关节镜下喙锁韧带增强术治疗肩锁关节脱位  

Arthroscopic treatment of acute acromioclavicular joint dislocations by coracoacromial ligament augmentation and suture

作　　者：皇甫小桥[1] 赵金忠[1] 何耀华[1] 杨星光[1] 刘旭东[1] 刘闻欣[1] 王海明[1] 

机构地区：[1]上海交通大学附属第六人民医院关节镜外科,200233

出　　处：《中华肩肘外科电子杂志》2013年第1期40-45,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的：研究关节镜下缝线钢板增强喙锁韧带术治疗肩锁关节脱位的近期治疗效果。方法2010年3月至2011年3月,在关节镜下使用膝关节韧带重建技术的缝线钢板(德国 ASCULAP 公司, B′BRAUN)增强重建喙锁韧带(三角韧带与斜方韧带),治疗 Rockwood Ⅲ型9例、Ⅴ型3例新鲜肩锁关节脱位。行 X线片、美国肩肘关节外科医师(America Shoulder Elbow Surgeons,ASES)评分和 Constant 评分,随访12~18个月。结果 ASES 评分：术前28.7分,术后86.9分；Constant 评分：术前24分,术后91分。治疗组 X线片显示,肩锁关节复位良好。术后1年,91.7%(11/12)病例获得满意治疗效果,83.3%(10/12)恢复到术前运动水平,仅有1例出现肩锁关节半脱位。结论关节镜下缝线钢板喙锁韧带增强术治疗肩锁关节脱位,早期可以获得满意的治疗效果,术后复位良好,并发症少。Objective Acromioclavicular joint dislocation is commonly seen in shoulder joint injuries. Dysfunction as well as pain and discomfort usually occurred when the integrity of shoulder is damaged,for the acromioclavicular (AC)joint is involved in the connection between the scapula and the body as well as the activities of shoulder joint.Therefore,a consensus has been reached to treat severe AC joint dislocation by surgery.Based on different anatomical and functional cognition,methods for AC joint dislocation are various,which are typically performed by incision to reconstruct its stability and restore function.Attempts had been made by many doctors in the reconstruction of AC joint dislocation with the development of arthroscopy.From March 2010 to March 2011,obvious therapeutic effect was obtained in treating Rockwood type Ⅲ and Ⅴ AC joint dislocation arthroscopically with the suture plate used for the reconstruction of ligaments of knee joint to augment the reconstructed CC ligaments (conoid ligament and trapezoid ligament).Methods From March 2010 to March 2011,nine patients with acute AC joint dislocation type Ⅲ and three patients with type V were treated arthroscopically to augment the reconstructed CC ligaments (conoid ligament and trapezoid ligament ) by the suture plate (ASCULAP Company, Germany,B′Braun)used to reconstruct ligaments of knee joint.Patients were pre and postoperatively evaluated with X-ray examinations,American Shoulder and Elbow Surgeons′Form (ASES)and Constant-Murley Score (CMS).Results All 1 2 patients were followed up for at least 1 2 months (range,1 2 to 1 8 months).The average ASES score significantly increased from 28.7 preoperatively to 86.9 postoperatively, and the mean CMS score from 24 to 91,respectively.X-ray data showed a good reduction of the AC joint in the treated group.9 1 .7% of patients (1 1 patients)obtained an obvious therapeutic effect after operation. 83.3% of patients (10 patients)returned to their pre-injury level of athletics.Acromioclavicular subluxation was

关 键 词：肩锁关节脱位 喙锁韧带 关节镜 

分 类 号：R687.4[医药卫生—骨科学]