双RigidLoop悬吊钛板重建喙锁韧带联合肩锁韧带修复治疗急性肩锁关节脱位的早期疗效观察  

Early efficacy of coracoclavicular ligament reconstruction with double RigidLoop suspension plate combined with acromioclavicular ligament repair for the treatment of acute acromioclavicular joint dislocation

作　　者：倪建龙[1] 宋启春[1] 赵莎妮 第五勇刚 危望 冯萌 党晓谦[1] 时志斌[1] Ni Jianlong;Song Qichun;Zhao Shani;Di Wu Yonggang;Wei Wang;Feng Meng;Dang Xiaoqian;Shi Zhibin(First Department of Orthopedics,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;Department of Orthopaedics,Affiliated Hanjiang Hospital of Xi’an Medical University,Hanzhong,Shaanxi 723000,China)

机构地区：[1]西安交通大学第二附属医院骨一科,西安710004 [2]西安医学院附属汉江医院骨科,陕西汉中723000

出　　处：《创伤外科杂志》2022年第1期29-34,共6页Journal of Traumatic Surgery

基　　金：陕西省重点研发计划-高校联合项目(2020GXLH-Y-011)。

摘　　要：目的比较双RigidLoop悬吊钛板重建喙锁韧带联合肩锁韧带修复与钩钢板治疗RockwoodⅢ型急性肩锁关节脱位的早期临床疗效。方法回顾性分析2016年3月—2019年5月西安交通大学第二附属医院骨一科收治的RockwoodⅢ型急性肩锁关节脱位患者58例,男性41例,女性17例;年龄20~65岁,平均38.9岁。根据手术方法不同分为悬吊钛板组(28例)和钩钢板组(30例),悬吊钛板组采用双RigidLoop悬吊钛板重建喙锁韧带联合肩锁韧带修复方法治疗,钩钢板组采用钩钢板方法治疗。比较两组患者手术时间、切口长度、术中出血量和住院时间;并比较两组患者术前及术后3、6、12个月的视觉模拟评分(VAS)、上肢功能(DASH)评分和Constant-Murley评分。结果患者均获得门诊随访,时间12~20个月,平均13.5个月。悬吊钛板组切口长度与住院时间短于钩钢板组(5.35±0.27)cm vs.(8.42±0.51)cm,(7.24±1.13)d vs.(9.67±1.25)d,P<0.05,两组患者手术时间和术中出血量比较差异无统计学意义(50.82±5.12)min vs.(49.76±5.73)min,(85.24±10.12)mL vs.(89.15±11.45)mL,P>0.05。两组患者术后VAS、DASH评分和Constant-Murley评分较术前均显著好转,且随着时间延长,评分均不断好转。悬吊钛板组与钩钢板组术后3、6、12个月VAS(3.12±0.14)分vs.(4.25±0.18)分,(2.08±0.12)分vs.(3.15±0.22)分,(0.91±0.05)分vs.(1.52±0.13)分、DASH评分(25.19±7.45)分vs.(32.34±8.13)分,(11.76±5.52)分vs.(12.88±6.63)分,(2.95±1.64)分vs.(3.25±1.15)分和Constant-Murley评分(75.72±11.91)分vs.(68.37±12.45)分,(84.32±13.44)分vs.(77.51±15.66)分,(96.19±16.45)分vs.(88.38±20.32)分比较差异均有统计学意义(P<0.05)。结论双RigidLoop悬吊钛板重建喙锁韧带联合肩锁韧带修复治疗RockwoodⅢ型急性肩锁关节脱位具有切口更小、疼痛缓解更好、功能恢复更快、住院时间更短、无需二次手术等优势,值得临床推广。Objective To compare the early clinical efficacy of coracoclavicular ligament reconstruction with double RigidLoop suspension plate combined with acromioclavicular ligament repair and clavicular hook plate for the treatment of RockwoodⅢacute acromioclavicular joint dislocation.Methods From Mar.2016 to May 2019,58 patients with RockwoodⅢacute acromioclavicular joint dislocation were enrolled in the study retrospectively,who were treated in the First Department of Orthopaedics of the Second Affiliated Hospital of Xi’an Jiaotong University.There were 41 males and 17 females,aged 20-65 years with an average age of 38.9 years.According to different surgical methods,the patients were divided into two groups:the suspended plate group(28 cases)and the hook plate group(30 cases).The suspended plate group was treated with double RigidLoop suspended plate for coracoclavicular ligament reconstruction combined with acromioclavicular ligament repair,and the hook plate group was treated with the hook plate method.The operative time,incision length,intraoperative blood loss and hospital stay were compared.The visual anglogue scale(VAS),DASH score,and Constant-Murley score of 3 months,6 months and 12 months postoperatively were compared between the two groups.Results All patients were followed up for 12 to 20 months,with an average of 13.5months.Compared with the hook plate group,the suspension plate group had advantages in incision length and hospital stay,and the difference was statistically significant[5.35±0.27 vs.8.42±0.51(cm);7.24±1.13 vs.9.67±1.25(days)].There was no significant difference in operative time or intraoperative blood loss between the two groups[50.82±5.12 vs.49.76±5.73(minutes);85.24±10.12 vs.89.15±11.45(mL)].The postoperative VAS,DASH score and Constant-Murley score of two groups were significantly improved compared with the preoperative scores,and the scores were continuously improved with the extension of time.The VAS(3.12±0.14 vs.4.25±0.18;2.08±0.12 vs.3.15±0.22;0.91±0.05 vs.1.52±0.13)

关 键 词：肩锁关节脱位 悬吊钛板 钩钢板 疗效 

分 类 号：R684.7[医药卫生—骨科学]