肩锁韧带重建与锁骨钩板肩锁关节内固定在带线锚钉重建喙锁韧带治疗肩锁关节脱位中的疗效比较  

Comparison of reconstruction of acromioclavicular ligament versus internal fixation of acromioclavicular joint with clavicle hook plate in treatment of acromioclavicular dislocation by reconstruction of coracoclavicular ligament with suture anchor

作　　者：鲍飞龙 姬广伟 亢世杰 江涛 黄东生 吕夫新 刘涛 Bao Feilong;Ji Guangwei;Kang Shijie;Jiang Tao;Huang Dongsheng;Lyu Fuxin;Liu Tao(Department of Orthopaedic Trauma,Qilu Hospital of Shandong University(Qingdao),Qingdao 266035,China)

机构地区：[1]山东大学齐鲁医院(青岛)创伤骨科,266035

出　　处：《中华创伤骨科杂志》2021年第8期717-722,共6页Chinese Journal of Orthopaedic Trauma

摘　　要：目的比较肩锁韧带重建与锁骨钩板肩锁关节内固定在带线锚钉重建喙锁韧带治疗RockwoodⅢ~Ⅴ型肩锁关节脱位中的疗效。方法回顾性分析2015年1月至2019年6月山东大学齐鲁医院(青岛)创伤骨科治疗的56例肩锁关节脱位RockwoodⅢ~Ⅴ型患者资料。根据治疗方式不同分为2组:重建组26例(带线锚钉重建喙锁韧带联合肩锁韧带重建治疗),钢板组30例(带线锚钉重建喙锁韧带联合钩钢板内固定治疗),比较两组患者手术时间、术中出血量及末次随访时Constant-Murley肩关节评分及肩关节主观评分系统(SSRS)评分及并发症情况等。结果重建组与钢板组患者术前一般资料比较差异均无统计学意义(P>0.05),有可比性。重建组患者术后获6~15个月(平均7.9个月)随访,钢板组患者术后获7~18个月(平均11.3个月)随访。重建组与钢板组患者手术时间分别为(79.9±12.6)、(69.1±8.5)min,差异有统计学意义(P<0.05);术中出血量分别为(68.5±19.1)、(65.0±16.6)mL,差异无统计学意义(P>0.05)。末次随访时重建组与钢板组Constant-Murley肩关节评分分别为(87.9±3.4)、(91.9±3.5)分,SSRS评分分别为(85.1±4.1)、(88.6±3.0)分,以上项目两组间比较差异均有统计学意义(P<0.05)。重建组所有患者切口愈合良好,1例出现切口区周围麻木,术后3个月恢复。钢板组2例切口出现感染;1例出现切口发红、渗出,换药术后3周愈合;1例出现切口区周围麻木,术后5个月恢复。结论肩锁韧带重建与锁骨钩板肩锁关节内固定在带线锚钉重建喙锁韧带治疗肩锁关节脱位均能获得较好的临床疗效,喙锁韧带、肩锁韧带同时重建手术时间较长,但后者在Constant-Murley肩关节评分及SSRS肩关节主观评分及并发症等方面均有明显优势,同时可避免二次手术。Objective To compare reconstruction of acromioclavicular ligament versus internal fixation of acromioclavicular joint with clavicle hook plate in the treatment of RockwoodⅢ-Ⅴacromioclavicular dislocation by reconstruction of coracoclavicular ligament with suture anchor.Methods A retrospective analysis was conducted of the 56 patients who had been treated for RockwoodⅢ-Ⅴacromioclavicular dislocation from January 2015 to June 2019 at Department of Orthopaedic Trauma,Qilu Hospital of Shandong University(Qingdao).Of them,26 were treated by reconstruction of coracoclavicular ligament with suture anchor plus reconstruction of acromioclavicular ligament(reconstruction group)and 30 by reconstruction of coracoclavicular ligament with suture anchor plus internal fixation of acromioclavicular joint with clavicle hook plate(plate group).The 2 groups were compared in terms of operation time,intraoperative blood loss,Constant-Murley score and Subjective Shoulder Rating System(SSRS)score at the last follow-up,and complications.Results The 2 groups were comparable because there were no significant differences between them in the baseline data before operation(P>0.05).The reconstruction group was followed up for 6 to 15 months(average,7.9 months)while the plate group for 7 to 18 months(average,11.3 months).The average operation time was(79.9±12.6)min for the reconstruction group and(69.1±8.5)min for the plate group,showing a significant difference(P<0.05).No significant difference was found between the 2 groups in the intraoperative blood loss[(68.5±19.1)mL versus(65.0±16.6)mL](P>0.05).The differences were statistically significant between the 2 groups in Constant-Murley score(87.9±3.4 for the reconstruction group versus 91.9±3.5 for the plate group)and in SSRS score(85.1±4.1 for the reconstruction group versus 88.6±3.0 for the plate group)(P<0.05).All the wounds healed well in the reconstruction group except for one patient who reported numbness around the wound which disappeared spontaneously 3 months postoperat

关 键 词：肩脱位 修复外科手术 韧带 骨折固定术 内 

分 类 号：R687.4[医药卫生—骨科学]