三重带袢钢板技术治疗新鲜RockwoodⅢ型肩锁关节脱位手术创伤与临床疗效相关性研究  

Correlation study of surgical trauma and clinical efficacy of triple Endobutton technique in the treatment of fresh Rockwood typeⅢacromioclavicular dislocation

作　　者：钟浩博[1] 刘伟乐[1] 刘正蕊 郑少伟[1] 黄守镔 孙江森[1] 孙春汉[1] 李胜发[1] Zhong Haobo;Liu Weile;Liu Zhengrui;Zheng Shaowei;Huang Shoubin;Sun Jiangsen;Sun Chunhan;Li Shengfa(Department of Orthopedic,Huizhou First People's Hospital,Huizhou 516001,China;Zhangzhou Health Vocational College,Zhangzhou 363000,China)

机构地区：[1]惠州市第一人民医院骨外科,516001 [2]漳州卫生职业学院,36300

出　　处：《中华肩肘外科电子杂志》2020年第4期327-334,共8页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：惠州市科技计划(2020Y049);广东省中医药局中医药科研项目(20202215);惠州市科技计划(2012Y053);惠州市科技计划(2011Y045)。

摘　　要：目的对比AO锁骨钩钢板和三重带袢钢板技术治疗新鲜RockwoodⅢ型肩锁关节脱位患者手术创伤和临床疗效指标,并进一步在优势组中行相关性分析,探究优势组中影响临床疗效相关因素,为此类疾病手术治疗改进提供借鉴.方法回顾性分析惠州市第一人民医院自2018年1月至2020年5月符合新鲜RockwoodⅢ型肩锁关节脱位患者72例,根据手术方式不同分为AO组(A组)和三重Endobutton带袢钢板组(B组).其中A组(n=37,F/M=12/25),平均年龄(41.30±1.02)岁;B组(n=35,F/M=13/22),平均年龄(43.36±1.15)岁.所有患者术后1 d、1周、1个月、3个月、1年均行X线检查.X线中测量喙锁间距、肩锁间距评估手术复位,视觉模拟评分(visual analogue scale/score,VAS)和Constant-Murley肩关节功能评分评估临床疗效.通过Graphpad Prism 7软件进行数据分析.年龄、返工时间、受伤至手术花费时间、手术持续时间、手术切口长度、术中出血量、VAS评分、Constant-Murley肩关节功能评分、喙锁间距和肩锁间距采用x-±s表示;性别、受伤位侧采用数量表示.计量资料组间比较用t检验分析,计数资料组间用卡方检验分析,相关性分析均采用Pearson相关性分析,P<0.05为差异具有统计学意义,r>0为正相关.结果72例患者依据12个月随访,Constant-Murley肩关节功能评分结果:A组术后1 d(46.60±0.41)分、术后1周(65.22±0.45)分和B组术后1 d(51.30±0.39)分、术后1周(75.07±0.35)分相比较,术后1 d和术后1周A组分数均明显小于B组,差异具有统计学意义(P<0.05).VAS结果提示:A组术后1 d(6.71±0.07)分、术后1周(5.45±0.09)分、术后1个月(3.70±0.11)分和B组术后1 d(5.70±0.10)分、术后1周(3.60±0.14)分、术后1个月(2.00±0.10)分相比较,A组分数均明显大于B组,差异具有统计学意义(P<0.05).返工时间结果示:A组(7.64±0.10)周明显长与B组(6.01±0.17)周,差异有统计学意义(P<0.05).相关性提示:B组手术切口长度与术后1 dVAS评Background Acromioclavicular joint dislocation is a clinically common disease and caused by trauma violence.Patients often felt severe shoulder pain with limited mobility,seriously affecting daily life and work.Rockwood classification was mostly used in this disease.Because of its dislocation severity,damage structure characteristics and other reasons,the clinical treatment options of type III patients are often controversial.Fresh Rockwood Ⅲ-Ⅳ type patients are clinically taken more surgical treatment,but the method is different.With the progress of materials and surgical concepts,new surgical techniques are becoming more widely used,and choosing a treatment that patients with this disease could get more benefits is a key issue for surgeons.Objective By collecting and comparing the surgical trauma and clinical efficacy indexes of AO clavicular hook plate and triple Endobutton technique in the treatment of fresh Rockwood type Ⅲ acromioclavicular dislocation,the correlation analysis was further carried out in the dominant group to explore the factors affecting the clinical efficacy,so as to provide reference for the improvement of surgical treatment of this kind of disease.Methods From January 2018 to May 2020,the data of 72 patients with fresh Rockwood type Ⅲ acromioclavicular dislocation were retrospectively analyzed.The patients were divided into AO clavicular hook plate group(Group A) and triple Endobutton group(Group B) according to the different operation methods.In Group A(n=37,F/M=12/25),the average age was(41.30±1.02) years,and in the Group B(n=35,F/M=13/22),the average age was(43.36±1.15)years.The X-ray examinations were performed on the 1 st day,1 st week,1 st month,3 rd month and 1 year after surgery.Coracoclavicular joint distance and acromioclavicular joint distance were measured to evaluate the surgery reduction.The visual analogue scale(VAS) and Constant-Murley score were used to evaluate the clinic efficacy.The data were analyzed with Graphpad Prism 7 software.The age,rework time,injury

关 键 词：带袢钢板 肩锁关节脱位 市第一人民医院 视觉模拟评分 肩关节功能 手术切口 疗效指标 手术复位 

分 类 号：R687.3[医药卫生—骨科学]