急性不稳定肩锁脱位关节镜下TightRope~?固定与锁骨钩板固定的短期疗效比较  

Comparison on the short-term outcomes of arthroscopic Tight Rope~? fixation and hook plate fixation in acute unstable acromioclavicular joint dislocation

作　　者：刘弼 陈蓟 黄雪晴 肖云敏 朱彩云 LIU Bi;CHEN Ji;HUANG Xue-qing;XIAO Yun-min;ZHU Cai-yun(Department of Orthopaedics,Shenzhen People's Hospital,Shenzhen 518020,Guangdong,CHINA;Shenzhen People's Hospital,Shenzhen 518020,Guangdong,CHINA)

机构地区：[1]深圳市人民医院骨科,广东深圳518020 [2]深圳市人民医院放射科,广东深圳518020

出　　处：《海南医学》2019年第16期2075-2078,共4页Hainan Medical Journal

基　　金：广东省深圳市科技计划项目(编号：JCYJ20170307100726777)

摘　　要：目的比较急性不稳定肩锁关节脱位患者关节镜下TightRope?固定与锁骨钩钢板固定的短期疗效。方法对深圳市人民医院骨科2014年12月至2017年12月间收治且获得随访的42例RockwoodⅢb型及以上急性肩锁关节脱位患者进行了回顾性研究,所有患者均采用关节镜下TightRope?固定或开放手术锁骨钩钢板固定治疗,按手术方式分为两组,其中TightRope?固定组25例,锁骨钩钢板组17例。比较两组患者的手术时间、术中出血量、肩关节Constant评分、加州大学洛杉矶分校(UCLA)肩部评分、视觉模拟评分(VAS)以及X光片下喙锁间距(CCD)等指标,且统计各组并发症情况。结果两组患者在年龄、性别、体质量指数、受伤至手术时间、住院时间以及术前的Constant评分、UCLA肩部评分、VAS评分和CCD等方面比较差异均无统计学意义(P>0.05);TightRope?组患者的手术时间为(64±19)min,明显长于锁骨钩钢板组的(48±10)min,出血量为(28.8±8.5)mL,明显少于锁骨钩钢板组的(102±20.6)mL,差异均有统计学意义(P<0.05);术后6个月,TightRope?组患者的肩关节外展(140±22)°,明显大于锁骨钩钢板组的(125±10)°,差异有统计学意义(P<0.05),而患肩前屈功能、Constant评分、UCLA肩部评分、VAS评分、CCD等两组比较差异均无统计学意义(P>0.05);术后1年,TightRope?组患者的肩关节Constant评分(88.5±12.5)分,明显高于锁骨钩钢板组的(76.9±13.2)分,差异有统计学意义(P<0.05),而患肩前屈外展功能、UCLA肩部评分、VAS评分、CCD等比较差异均无统计学意义(P>0.05);TightRope?组患者无并发症发生,锁骨钩钢板组有3例,差异有统计学意义(P<0.05)。结论急性不稳定肩锁关节脱位关节镜下TightRope?固定与钩钢板固定相比,具有创伤小、出血更少、恢复更快、短期临床结果更好以及并发症更少等优点,是治疗急性不稳定肩锁关节脱位的一个很好选择。Objective To compare the short-term outcomes of arthroscopic TightRope? fixation and clavicular hook plate fixation in patients with acute unstable acromioclavicular joint dislocation.Methods A retrospective study was conducted on 42 patients with acute acromioclavicular joint dislocation of Rockwood typeⅢb and above who were treated and followed up in Department of Orthopaedics,Shenzhen People's Hospital from December 2014 to December 2017.The patients were treated with arthroscopic TightRope?fixation(TightRope?group,n=25)or open operation with clavicular hook plate fixation(clavicular hook plate group,n=17).The duration of surgery,intraoperative bleeding volume,shoulder Constant score,University of California,Los Angeles(UCLA)shoulder score,Visual Analogue Score(VAS)and X-ray coracoclavicular distance(CCD)were compared between the two groups,and the complications of each group were analyzed.Results There were no statistically significant differences in age,gender,body mass index,time from injury to operation,length of hospital stay,preoperative Constant score,UCLA shoulder score,VAS score,and CCD between the two groups(P>0.05).The duration of surgery in TightRope?group was(64±19)min,which was significantly longer than(48±10)min of clavicular hook plate group.The bleeding volume was(28.8±8.5)mL,significantly less than(102±20.6)mL in clavicular hook plate group(P<0.05).Six months after operation,the shoulder joint abduction in TightRope?group was(140±22)°,significantly greater than(125±10)°in clavicular hook plate group(P<0.05);there was no statistically significant difference in shoulder flexion function,Constant score,UCLA shoulder score,VAS score,and CCD between the two groups(P>0.05).One year after operation,the Constant score of shoulder joint in Tight-Rope?group was 88.5±12.5,significantly higher than 76.9±13.2 in clavicular hook plate group(P<0.05);there were no statistically significant difference in shoulder flexion and abduction function,UCLA shoulder score,VAS score,and CCD(P>0.05).No case

关 键 词：肩锁关节 关节脱位 关节镜 锁骨钩钢板 内固定 

分 类 号：R684[医药卫生—骨科学]