关节镜辅助下同种异体肌腱解剖重建喙锁韧带治疗肩锁关节脱位(RockwoodⅢ~Ⅴ型)的临床效果  

Clinical effect of arthroscopically assisted allograft tendon anatomic reconstruction of coracoclavicular ligament in treatment of acromioclavicular joint dislocation(Rockwood typeⅢ-Ⅴ)

作　　者：熊国安[1] 谢静波[1] 肖义兵 熊俊伟 丁超 XIONG Guo-an;XIE Jing-bo;XIAO Yi-bing;XIONG Jun-wei;DING Chao(Department of Orthopedics,Fengcheng People′s Hospital,Jiangxi Province,Fengcheng 331100,China)

机构地区：[1]江西省丰城市人民医院骨一科,江西丰城331100

出　　处：《中国当代医药》2021年第27期94-97,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202140838)。

摘　　要：目的探讨关节镜辅助下同种异体肌腱解剖重建喙锁韧带治疗肩锁关节脱位(RockwoodⅢ~Ⅴ型)的临床效果。方法回顾性选取2018年6月至2020年1月丰城市人民医院收治的84例肩锁关节脱位患者作为研究对象,按照治疗方法分为常规组(42例)与观察组(42例),观察组实施关节镜辅助下同种异体肌腱解剖重建喙锁韧带治疗,常规组实施切开复位钩钢板固定治疗。比较两组的上肢功能、肩关节功能、疼痛程度。结果观察组治疗后3 d、6周的上肢功能评分(DASH)低于常规组、Constant-Murley肩关节功能评分高于常规组,差异有统计学意义(P<0.05)。观察组治疗后3 d、6周的视觉模拟评分(VAS)低于常规组,差异有统计学意义(P<0.05)。治疗后6、12个月,两组的DASH评分、肩关节功能评分、VAS评分比较,差异无统计学意义(P>0.05)。两组在随访期间均未发生固定失效、再次脱位及同种异体肌腱排异反应。结论肩锁关节脱位患者实施关节镜辅助下同种异体肌腱解剖重建喙锁韧带治疗,能够显著缓解患者的疼痛感,改善患者肩关节功能,值得推广。Objective To explore the clinical effect of arthroscopically assisted allograft tendon anatomic reconstruction of coracoclavicular ligament in the treatment of acromioclavicular joint dislocation(Rockwood typeⅢ-Ⅴ).Methods Eighty-four patients with acromioclavicular joint dislocation treated in Fengcheng People′s Hospital from June 2018 to January 2020 were retrospectively selected as research subjects,and were divided into the routine group(n=42)and the observation group(n=42)according to the treatment.The observation group was given arthroscopically assisted allograft tendon anatomic reconstruction of coracoclavicular ligament,and the routine group was given open reduction and hook plate fixation.The upper limb function,shoulder joint function and pain degree of the two groups were compared.Results The disability of arm shoulder and hand(DASH)at 3 days and 6 weeks after treatment in the observation group were lower than those in the routine group,and the shoulder joint function scores(Constant-Murley)in the observation group were higher than those in the routine group,the differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores at 3 days and 6 weeks after treatment in the observation group were lower than those in the routine group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the DASH score,Constant-Murley score,VAS score before treatment and at 6 and 12 months after treatment between the two groups(P>0.05).During the follow-up period,there was no fixation failure,re-dislocation or allogeneic tendon rejection in the two groups.Conclusion For patients with acromioclavicular joint dislocation,the arthroscopically assisted allograft tendon anatomic reconstruction of coracoclavicular ligament can significantly relieve the pain of patients and improve the function of the shoulder joint,which is worthy of promotion.

关 键 词：关节镜技术 同种异体肌腱 喙锁韧带重建 肩锁关节脱位 

分 类 号：R687.4[医药卫生—骨科学]