自体掌长肌移植重建喙锁韧带结合带线锚钉固定治疗肩锁关节脱位的疗效  

Transplantation of autogenous palmaris longus tendon combined with suture anchor fixation in the treatment of aromioclavicular dislocations

作　　者：罗吉伟[1] 余斌[1] 魏宽海[1] 覃承诃[1] 胡岩君[1] 

机构地区：[1]南方医科大学南方医院创伤骨科,广州510515

出　　处：《中华肩肘外科电子杂志》2014年第1期25-29,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的观察自体掌长肌移植重建喙锁韧带结合带线锚钉固定治疗肩锁关节脱位的治疗效果。方法自2011年5月至2012年5月,收治Rockwood分型Ⅲ度以上的肩锁关节脱位患者30例,以自体掌长肌移植重建喙锁韧带,强生带线锚钉固定维持锁骨于复位状态,观察疗效,包括X线片检查复位效果及Roekwood肩关节功能评分。结果术后对30例患者进行随访,平均随访16个月,术后12个月的患肢肩关节Rockwood评分,优25例(83.33%),良4例(13.33%),可1例(3.33%),差0例(0%),优良率96.7%。结论白体掌长肌移植重建喙锁韧带结合带线锚钉固定治疗肩锁关节脱位效果优良,可成为治疗肩锁关节脱位的一种较好的选择。Background Clinically,acromioclavicular dislocation is a common disease.Whether surgical treatment should be taken or not depends on the type and degree of the inj ury,as well as the symptoms,ages,occupation,exercise requirements,and other factors of patients.Acromioclavicular dislocation can be classified as six types (degrees)according to Rockwood.The injury with obvious symptoms above Ⅲ degree is generally considered as an important operation indication.The key point in the surgical treatment of acromioclavicular dislocation is to select appropriate methods for the acromioclavicular joint fixation after reduction.There are many choices of the internal fixation to fix the acromioclavicular joint,such as the Kirschner wire and tension band,the clavicular hook plate or anatomical plate for the coracoclavicular joint fixation,and the cannulated screws,steel wires or suture anchors for the coracoclavicular fixation.The selection of these fixations can be combined with debridement of the acromioclavicular joint,the distal clavicle resection,or stitching and reconstruction of the coracoclavicular ligament.Most of these surgical procedures have obtained better results. However,the internal fixation failure,displacement or dislocation after the fixation removal sometimes happened.Considering that the coracoclavicular ligament plays an important role for the acromioclavicular joint stability,researchers has gradually paid more attentions to the reconstruction of the coracoclavicular ligament recently.The repair methods include the direct suture,the partial ligament displacement,the autologous tendon graft,and the tendon graft transplantation.We chose a simple,less traumatic method for the acromioclavicular dislocations,which is autogenous palmaris longus muscle transplant combined with the suture anchor fixation,and achieved satisfactory results. Methods (1)General information:A total of 30 cases aged from 17 to 55 years (mean 31 years)with acromioclavicular dislocations of Rockwood type Ⅲ,Ⅳ or Ⅴ were collected

关 键 词：肩锁关节脱位 掌长肌 重建 带线锚钉 

分 类 号：R687.3[医药卫生—骨科学]