同种异体肌腱重建韧带技术与Endobutton技术治疗肩锁关节脱位的疗效比较  

A retrospective comparative study in the treatment of acromioclavicular joint dislocation:ligaments reconstruction with allogenic tendon versus Endobutton technique

作　　者：王古衡 李双 陈亚兰[2] 邢树国 侯建伟 茅天 谭军 邓爱东 谢仁国 Wang Guheng;Li Shuang;Chen Yalan;Xing Shuguo;Hou Jianwei;Mao Tian;Tan Jun;Deng Aidong;Xie Renguo(Department of Hand Surgery,Affiliated Hospital of Nantong University,Jiangsu 226001,China;Department of Medical Informatics,Nantong University,Jiangsu 226001,China;Department of Orthopedics,the Third People's Hospital of Nantong,Jiangsu 226000,China;Department of Hand Surgery,Shanghai General Hospital,Shanghai 201620,China)

机构地区：[1]南通大学附属医院手外科,江苏226001 [2]南通大学医学信息学系,江苏226001 [3]南通市第三人民医院骨科,江苏226000 [4]上海市第一人民医院手外科,201620

出　　处：《中华手外科杂志》2020年第2期99-102,共4页Chinese Journal of Hand Surgery

基　　金：南通大学杏林学院自然科学研究项目(2018K133);南通大学创新创业训练计划项目(2018158)。

摘　　要：目的比较同种异体肌腱重建斜方韧带、锥状韧带和肩锁韧带技术与Endobutton复位固定技术治疗肩锁关节脱位的临床疗效差异。方法自2010年2月到2016年8月,我们对16例肩锁关节脱位患者进行治疗,其中8例采用同种异体肌腱重建斜方韧带、锥状韧带和肩锁韧带上下两部分,另8例采用Endobutton技术重建喙锁韧带。随访调查患者总体满意度,观察患肩外形,测量肩关节活动度,摄X线片评价肩锁关节复位维持情况,使用Constant-Murley肩关节评分和DASH评分评价肩关节和上肢功能恢复情况,视觉模拟评分法(visual analogue scale,VAS)了解患者疼痛情况。比较两种方法治疗后的随访结果。结果术后随访时间为34~60个月,平均48.8个月,所有患者均对治疗效果很满意或满意,肩关节外形正常。同种异体肌腱组Constant-Murley评分为94.5±5.2,DASH评分为2.1±2.6,VAS评分为0.4±1.1;Endobutton组Constant-Murley评分为92.8±3.7,DASH评分为2.2±2.0,VAS评分为0.3±0.7,两组比较差异均无统计学意义(P>0.05)。结论同种异体肌腱重建韧带技术与Endobutton技术治疗肩锁关节脱位均能获得较满意的疗效,而同种异体肌腱更接近生物力学要求,是一种有效的方法。Objective To compare the clinical efficacy of reconstruction of trapezium ligament,conoid ligament and acromioclavicular ligament with allogeneic tendon and Endoboutton reduction and fixation in the treatment of acromioclavicular joint dislocation.Methods From February 2010 to August 2016,16 patients with acromioclavicular joint dislocation were treated,including 8 patients who used allogeneic tendons to reconstruct trapezoid ligament,conoid ligament and the upper and lower parts of acromioclavicular ligament,and 8 patients who used Endobouton technique to reconstruct coracoclavicular ligament.The follow-up of patients'overall satisfaction,observation of shoulder shape,measurement of shoulder joint activity,X-ray evaluation of acromioclavicular joint reduction and maintenance were conducted.The Constant-Murley score and DASH score were used to evaluate the functional recovery of shoulder and upper extremity,and the visual analog scale(VAS)was used to obtain the pain of patients.The follow-up results of the two methods were compared.Results The follow-up period ranged from 34 to 60 months with an average of 48.8 months.All the patients were satisfied with the treatment results and the shape of shoulder joint was normal.In the allogeneic tendon group,the Constant-Murley score was 94.5±5.2,the DASH score was 2.1±2.6,and the VAS score was 0.4±1.1;in the Endobutton group,the Constant-Murley score was 92.8±3.7,the DASH score was 2.2±2.0,and the VAS score was 0.3±0.7.There were no significant differences between the two groups(P>0.05).Conclusion The technique of allogeneic tendon reconstruction and Endoboutton in the treatment of acromioclavicular joint dislocation can achieve satisfactory results,and the allogeneic tendon is more close to the biomechanical requirements,which is an effective method.

关 键 词：肩锁关节 脱位 同种异体肌腱 韧带重建 Endobutton技术 

分 类 号：R687[医药卫生—骨科学]