3枚裸Endobutton钢板联合Ultrabraid线Ⅴ型悬吊治疗肩锁关节脱位  

V-shaped suspension fixation with three pure Endobutton plates combined with Ultrabraid suture bundles for treatment of acromioclavicular joint dislocation

作　　者：沈锋[1] 陈雄[1] 洪志群[1] 康一凡 林国兵[1] 李远东[1] 

机构地区：[1]福州总医院第一附属医院骨科,福建省莆田市351100 [2]第二军医大学第三附属医院骨科

出　　处：《中国矫形外科杂志》2017年第24期2274-2278,共5页Orthopedic Journal of China

摘　　要：[目的]介绍3枚裸Endobutton钢板联合Ultrabraid线V型悬吊治疗肩锁关节脱位的技术方法。[方法]选择2015年6月~2017年1月本院肩锁关节脱位Rockwood分型Ⅲ~Ⅴ型患者15例,颈丛+臂丛神经阻滞麻醉,于肩锁关节内侧2 cm处向喙突作一4 cm纵切口,显露锁骨远端及喙突上方,用4 mm的克氏针在喙突上表面近基底部及锁骨远端2、4 cm处向下钻孔,形成3个骨通道。用Ultrabraid线2根分别在3枚裸Endobutton钢板作两两穿线操作成双股四束的"V"形,将3枚Endobutton钢板分别穿过3个骨通道,翻转后由助手下压复位肩锁关节,滑动收紧锁骨远端板上的Ultrabraid线并打结,透视观察肩锁关节复位情况。术后肩肘吊带悬吊保护4周,避免负重。[结果]15例患者均获得随访,随访时间3~18个月,平均(11.26±4.35)个月。依照肩锁关节脱位评分系统(ASSS):优11例,良4例。[结论]此法操作简便,单个纵切口,局部美观,创伤小,术野显露清楚,模仿解剖重建喙锁韧带,弹性固定,复位成功率高,伤口感染率低,并发症少,围手术期疼痛减少。远期效果仍有待进一步证实。[Objective] To introduce a novel technique of V-shaped suspension fixation with three pure Endobutton plates combined with Uhrabraid suture bundles for treatment of acromioclavicular joint dislocation. [Methods] From June 2015 to Jan- uary 2017, 15 patients with acromioclavicular joint dislocation of Rockwood type III - V were surgically treated with a novel technique in our hospital. Under cervical plexus and brachial plexus block anesthesia, a 4cm longitudinal incision was made from 2cm medial to the acromioclavieular joint to the coraeoid process for exposing the distal clavicle and upper surface of eora- coid. Three penetrated bone tunnels were individually created with a 4ram pin at the eoracoid process near the root and at the clavicle 2era and 4cm medial to the distal end. Two Ultrabraid sutures were regularly threaded into the holes in the 3 Endobut- ton plates to form V- shaped double loops with 4 Ultrabraid bundles. The central plate was introduced through the eoracoid tun- nel top -down to fit the bottom of coracoid process, while the plates on the two ends were respectively inserted through the two clavicle tunnels down-up to seat the upper surface of the bone. With assistance of manipulative reduction of aeromioclavieular joint, the sutures were continuously tightened, then tied over the plates after the complete reduction verified by C-arm image in- tensifier. Postoperatively a sling was used for 4 weeks to avoid weight bearing. [Results] The 15 patients were followed up for 3 to 18 months with an average of 11.26±4.35 months. According to the acromioclavieular joint dislocation scoring system （ASSS） , the results were graded as excellent in 11 patients and good in 4 patients. [Conclusion] This novel technique has ad- vantages of easy operation in a single longitudinal incision with minimal trauma and cosmetic appearance to expose surgical field clearly, imitating the anatomy of coracoclavicular ligament with elastic fixation, and achieving high successful rate of com-plete reduction with less

关 键 词：肩锁关节脱位 ENDOBUTTON钢板 Ultrabraid缝线 

分 类 号：R687.4[医药卫生—骨科学]