双Endobutton联合带线铆钉治疗RockwoodⅢ~Ⅴ型肩锁关节脱位  

Double Endobutton combined with suture twinfix in treatment of RockwoodⅢtoⅤacromioclavicular joint dislocation

作　　者：应璞 戴小宇[2] 蒋晓伟[1] 许岳[1] 沈影超[1] 王强[1] YING Pu;DAI Xiao-yu;JIANG Xiao-wei;XU Yue;SHEN Ying-chao;WANG Qiang(Department of Orthopedics,Changshu Hospital Affiliated to Nanjing University of Chinese Medicine,Changshu Jiangshu 215500,China;Department of Orthopedics,Changzhou First People’s Hospital/Third Affiliated Hospital of Soochow University,Changzhou Jiangsu 213000,China)

机构地区：[1]南京中医药大学常熟附属医院骨科,江苏常熟215500 [2]苏州大学附属第三医院/常州市第一人民医院骨科,江苏常州213000

出　　处：《局解手术学杂志》2020年第10期796-800,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：常熟市科技局项目(CS201508)。

摘　　要：目的评估双Endobutton联合带线铆钉治疗RockwoodⅢ~Ⅴ型肩锁关节脱位的临床效果。方法回顾性分析南京中医药大学附属常熟医院2015年4月至2017年12月经双Endobutton联合带线铆钉方法治疗的48例RockwoodⅢ~Ⅴ型新鲜肩锁关节脱位患者的临床资料。分别于术前及术后1、3、6、12、24个月行疼痛视觉模拟量表(VAS)评分,肩关节功能Constant评分及美国肩肘外科协会(ASES)评分。通过复查肩关节正位X射线片以测量喙锁间距(CCD)、锁骨长度(CL)、锁骨隧道距离(CTD)、双隧道夹角(CCα),并由此计算锁骨隧道比例(CTR)和喙锁间距复位率(CCD ratio)。结果本研究48例患者随访24~30个月,平均26.6个月。VAS评分从术前(5.4±1.6)分降至术后24个月的(0.3±0.2)分,差异有统计学意义(P<0.05)。Constant评分和ASES评分从术前(43.6±12.4)分和(44.8±10.6)分提高至术后24个月的(96.3±3.4)分和(97.1±3.8)分,差异有统计学意义(P<0.05)。CCD从术前(15.3±5.9)mm缩短至术后24个月的(8.0±0.9)mm,CCD ratio由术前的90.1%降至术后24个月的2.4%,差异均有统计学意义(P<0.05)。锁骨隧道钻孔位置基本位于锁骨外侧1/5处,锁骨隧道与喙突隧道夹角平均值约为8.2°。结论双Endobutton联合带线铆钉治疗RockwoodⅢ~Ⅴ型肩锁关节脱位能够对喙锁韧带、肩锁韧带进行解剖重建,能有效促进关节早期稳定,患者可早期活动,无需手术取出内固定物,并发症少,临床疗效良好。Objective To evaluate the clinical effect of double Endobutton combined with suture twinfix in the treatment of RockwoodⅢtoⅤacromioclavicular joint dislocation.Methods Clinical data of 48 patients with Rockwood typeⅢtoⅤfresh acromioclavicular joint dislocation treated by double Endobutton combined with suture twinfix were retrospectively analyzed,and these patients were admitted into the orthopaedics department of Changshu Hospital Affiliated to Nanjing University of Chinese Medicine from April 2015 to December 2017.VAS score,Constant score and American Shoulder and Elbow Surgery(ASES)score were performed before operation and 1 month,3 months,6 months,12 months and 24 months after operation.The coracoclavicular distance(CCD),clavicular length(CL),clavicular tunnel distance(CTD)and clavicle and coracoid angle(CCα)were measured according to the anteroposterior X-rays check,and the clavicular tunnel ratio(CTR)and CCD ratio were caculated.Results All of the 48 cases were followed up for 24 to 30 months,with an average of 26.6 months.The VAS score was decreased from(5.4±1.6)preoperatively to(0.3±0.2)in 24 months after operation,the difference was significant(P<0.05).The Constant score and ASES score were increased from(43.6±12.4)and(44.8±10.6)preoperatively to(96.3±3.4)and(97.1±3.8)in 24 months after operation separately,and the differences were significant(P<0.05).CCD was shortened from(15.3±5.9)mm preoperatively to(8.0±0.9)mm in 24 months after operation(P<0.05),and the CCD ratio was decreased from 90.1%preoperatively to 2.4%in 24 months after operation(P<0.05).The drilling position of the clavicular tunnel was basically located at 1/5 of the lateral clavicle.The average angle between clavicular tunnel and coracoid tunnel was about 8.2°.Conclusion Double Endobutton combined with suture twinfix to treat RockwoodⅢtoⅤacromioclavicular joint dislocation can perform anatomical reconstruction of the coracoclavicular ligament and the acromioclavicular ligament.Meanwhile,it can effectively promote the

关 键 词：ENDOBUTTON 带线铆钉 肩锁关节脱位 喙锁韧带 喙锁间距复位率 肩锁韧带 重建 

分 类 号：R684.7[医药卫生—骨科学]