同种异体肌腱重建喙锁韧带联合锚钉内固定治疗肩锁关节脱位的疗效分析  

Reconstruction of coracoclavicular ligaments with allogeneic tendon graft combined with anchor fixation for acromiodavicular dislocation

作　　者：程刚[1] 季建华[1] 陈仲[1] 

机构地区：[1]云南省第二人民医院,昆明医科大学第四附属医院骨与创伤外科,昆明650021

出　　处：《中华创伤骨科杂志》2017年第11期986-988,共3页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨同种异体肌腱重建喙锁韧带联合锚钉内固定治疗肩锁关节脱位的疗效。方法回顾性分析2013年1月至2016年1月期间收治的24例肩锁关节脱位患者资料。男19例，女5例；年龄为21～46岁，平均31．4岁；左侧14例，右侧10例；脱位按Rockwood分型：Ⅲ型6例，Ⅳ型8例，Ⅴ型10例。所有患者均采取同种异体肌腱重建喙锁韧带联合锚钉内固定治疗。术后随访评价患者肩锁关节复位维持情况，使用上肢功能障碍评分量表（DASH）及肩关节Constant—Murley评分评价患者治疗前、后肩关节功能。结果所有患者术后获6～15个月（平均11．4个月）随访。拆除内固定锚钉后患者肩关节复位良好，其中优21例，良3例，优良率为100％。功能恢复时间为10．12个月，平均10．4个月。24例患者末次随访时DASH评分[（6．4±2．6）分]较术前[（10．7±3．0）分】显著改善，Constant．Murley评分[（92．2±4．7）分]较术前【（67．2±2．6）分]显著改善，差异均有统计学意义（P〈0．05）。术后患者满意度达83．3％（20／24），无不良反应发生。结论同种异体肌腱重建喙锁韧带联合锚钉内固定治疗肩锁关节脱位复位效果好，疗效确切，有助于患者肩关节功能的恢复。Objective To report treatment of acromiodavicular dislocation by reconstruction of cora- eoclavicular ligaments with allogeneic tendon graft and anchor internal fixation. Methods From January 2013 through January 2016, 24 patients with acromiodavicular dislocation were treated at our department. They were 19 men and 5 women, 21 to 46 years of age （average, 31.4 years）. Fourteen left and 10 right sides were involved. By Rockwood classification, 6 cases were type II1, 8 type IV and 10 type V. All of them were treated with reconstruction of coracoclavicular ligaments with allogeneic tendon graft and anchor internal fixation. Maintenance of the reduced acromioclavicular joint was followed up postoperatively. Disabilities of the Arm, Shoulder and Hand （DASH） scores and Constant-Murley shoulder scores were used to evaluate the shoulder functions before and after operation. Results All the patients were followed up for 6 to 15 months （average, 11.4 months）. The shoulder joints were well reduced after removal of anchor internal fixation. 21 cases were rated as excellent and 3 as good, giving a good to excellent rate of 100%. The fractures healed after 10 to 12 months （average, 10. 4 months）. Compared with the preoperative value （10.7 ＋ 3.0）, the DASH score at final follow-up was significantly improved （6. 4 ＋ 2.6） （ P 〈 0. 05）; compared with the preoperative value （67.2 ＋ 2.6）, the Constant-Murley score at final follow-up was also significantly improved （92.2 ＋4. 7） （ P 〈 0. 05）. The patients＇ satisfaction was 83.3% （20/24）. No adverse reaction occurred. Conclusion Reconstruction of coracoclavicular ligaments with allogeneic tendon graft combined with anchor fixation is a reliable technique for acromiodavicular dislocation.

关 键 词：移植 同种 肩锁关节 脱位 

分 类 号：R687[医药卫生—骨科学]