双束Endobutton解剖重建喙锁韧带治疗肩锁关节脱位的早期随访研究  

Anatomic coracoclavicular ligament double-buttons reconstruction for acute or chronic Rockwood type Ⅲ-V acromioclavicular joint dislocations: an early follow-up study

作　　者：徐海波 薛骋 宋李军[3] 李翔[3] 张浩[3] 方加虎[3] Xv Haibo;Xue Cheng;Song Lijun;Li Xiang;Zhang Hao;Fang Jiahu(Department of Orthopedics,Nanjing Qixia Hospital,Nanjing 210000,China;Department of Orthopedics,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China;Department of Orthopedics,First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京市栖霞区医院骨科,210000 [2]徐州医科大学附属医院骨科,221000 [3]南京医科大学第一附属医院骨科,210029

出　　处：《中华肩肘外科电子杂志》2019年第1期50-55,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：江苏省卫生计生委2015年度面上科研课题(H201503);南京市医学科技发展课题(YKK16288)

摘　　要：目的观察解剖重建喙锁韧带治疗RockwoodⅢ及以上肩锁关节脱位的临床疗效。方法选取22例肩锁关节脱位患者,其中男15例、女7例,新鲜脱位16例,陈旧性脱位6例,RockwoodⅢ型7例、Ⅳ型1例、V型14例。手术方式选择为双束Endobutton解剖重建技术。分别于术后3、6和12个月行疼痛视觉模拟评分及Constant肩关节功能评分,摄双侧肩关节正位X线片,测量患侧及健侧喙锁间距。结果此研究平均随访时间为(17.7±4.0)个月。疼痛视觉模拟评分从术前的平均5.0分下降到术后12个月的0.2分,Constant肩关节功能评分从术前的平均44.3分提高到术后12个月的93.7分。患侧喙锁间距从术前的平均21.0 mm下降到术后12个月的8.5 mm。所有病例随访过程中均无肩锁关节再脱位、锁骨喙突骨折等严重并发症发生。结论双束Endobutton解剖重建喙锁韧带是安全可靠的新术式,其应用于RockwoodⅢ-V型新鲜或者陈旧性肩锁关节脱位的手术治疗取得了良好的临床效果。Background In recent years,the incidence of acromioclavicular joint dislocation has been increasing.The main causes are falling from high places,car accidents and sports injuries.Rockwood et al.classified AC joint dislocation into 6 types,which has certain guiding significance for the choice of treatment methods.The conservative treatment of Rockwood type Ⅰ and Ⅱ dislocation is satisfactory,while type Ⅲ and other dislocations require surgical treatment to repair the completely broken coracoclavicular ligament.A large number of surgical methods for acromioclavicular joint dislocation have been reported in literatures,but the surgical choice is controversial.With the development of biomechanics research and material science,more and more surgeons tend to reconstruct coracoclavicular ligament to treat AC joint dislocation.Most surgeons regard the coracoclavicular ligament as a single bundle without reconstructing the trapezoidal ligament and the conical ligament separately.The double-bundle reconstruction reported in a few literatures is not an exact anatomical reconstruction.In this paper,we introduce a method of complete anatomical reconstruction of coracoclavicular ligament with double-bundle Endobutton loop-plate and Ethibond-2 suture according to the anatomy origin.The method was applied to 22 patients with type Ⅲ-Ⅴ acromioclavicular joint dislocation,including fresh or old injuries.They were followed up for at least 12 months to evaluate the early clinical outcome.Methods 1.Patient information:Twenty patients with acromioclavicular joint dislocation diagnosed by Jiangsu People's Hospital from August 2013 to June 2015 were included.Another 2 patients from September to December 2015 in Nanjing Qixia District Hospital were also included in this study.There were 15 males and 7 females,with an average age of 44.5(17-71)years.The dislocation of acromioclavicular joint was unilateral,including 9 cases on the left side,13 cases on the right side and 13 cases on the dominant side.The causes of injuries includ

关 键 词：肩锁关节脱位 喙锁韧带 解剖重建 斜方韧带 锥状韧带 

分 类 号：R687.4[医药卫生—骨科学]