全关节镜下治疗肩锁关节脱位  

Arthroscopic treatment of acromioclavicular joint dislocation

作　　者：汪国友[1] 沈骅睿[1] 曾胜强[1] 徐平[1] 邓凯[1] 扶世杰[1] 

机构地区：[1]泸州医学院附属中医医院骨科,646000

出　　处：《中华肩肘外科电子杂志》2014年第3期151-156,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的：探讨 Rockwood Ⅲ型急性肩锁关节脱位治疗方法,并比较两种喙锁韧带重建的临床疗效。方法回顾性分析自2010年1月至2013年6月收治的29例 Rockwood Ⅲ型急性肩锁关节脱位患者资料。经随机分组,其中16例在全关节镜下行自体半腱肌肌腱重建喙锁、肩锁韧带(自体韧带组),13例在全关节镜下行双 Endobutton 钢板结合爱惜帮线重建喙锁韧带(爱惜帮线组)。比较两组患者末次随访时的 Constant 评分及 CC-Dist 值的改善率。结果29例患者术后获得1~4年(平均2.5年)随访。末次随访时自体韧带组和爱惜帮线组患者 Constant 评分改善率分别为47.31%和47.01%,差异无统计学意义(t =0.136,P =0.893)。自体韧带组和爱惜帮线组患者 CC-Dist 值改善率分别为38.51%和43.16%,两组比较差异有统计学意义(t =-2.895,P =0.007)。结论全关节镜下行自体半腱肌肌腱重建喙锁、肩锁韧带和双 Endobutton 钢板结合爱惜帮线重建喙锁韧带均能有效改善肩关节功能,两者各有优势。Background The dislocation of acromioclavicular joint is a common injury clinically.This study is to investigate the treatment of acute acromioclavicular joint dislocation(Rockwood typeⅢ)and compare the clinical effect of two different ways of coracoclavicular ligament reconstruction.Methods We select the patients with fresh Rockwood type Ⅲ to V dislocation of acromioclavicular joint from January 2008 to June 2013.After randomization,16 cases received the reconstruction of coracoclavicular and acromioclavicular ligament arthroscopically with semitendinosus tendon(autogenous group).Among them,12 were males and 4 were females,aged 16-62 years old,the average age is 39.8years old.They were followed up for 9-39 months,the average follow-up was25.6months;13cases underwent the reconstruction of coracoclavicular ligament with the double Endobutton plate and Ethibond suture(Ethibond suture group),including 9cases of male,4cases of female,aging from 19 to 57years old,the average age is 36.5years old,were followed up for 12-35 months with a mean follow-up of 19.6 months.The reason of injury:12cases of traffic injuries,9cases of sports injury,4cases of fall,bruise in 2cases and 2cases of other injuries.The time between injury to operation was 3-11 d,averagely 6d.8patients were accompanied by SLAP injury of shoulder joint(5cases of autologous ligament group,3cases of Ethibond suture group),3patients were accompanied by rotator cuff injury(1cases of autologous ligament group,2cases of Ethibond suture group).2patients were combined with glenohumeral joint cartilage injury(1case of autologous ligament group 1case,1case of love help group),2patients were combined with Bankart injury(both in autologous ligament group),1 patient was combined with glenoid fracture(Ethibond suture group).The age,sex,cause of injury,injury side and time from getting injured to operation of the two groups are without significant differences(P >0.05).Autologous ligament group arthroscopic semitendinosus tendon reconstruction of coracoclavicular lig

关 键 词：关节镜 韧带重建 肩锁关节 脱位 

分 类 号：R687.4[医药卫生—骨科学]