三纽扣板可调悬吊固定治疗急性肩锁关节脱位的疗效分析  

Adjustable suspension fixation with three Endobutton plates for treatment of acute acromioclavicular joint dislocation

作　　者：岑景盛[1] 涂泽松[1] 谭志韵[1] 李宁[1] 罗汉文[1] CEN Jing-sheng;TU Ze-song;TAN Zhi-yun;LI Ning;LUO Han-wen(Department of Orthopaedics,Foshan Hospital of Traditional Chinese Medicine,Foshan,Guangdong,528000,China)

机构地区：[1]佛山市中医院骨科,广东528000

出　　处：《中国骨与关节杂志》2022年第7期537-541,共5页Chinese Journal of Bone and Joint

摘　　要：目的探讨三纽扣板可调悬吊固定治疗急性肩锁关节脱位的临床疗效。方法2018年1月至2019年12月,我科收治RockwoodⅢ型及以上急性肩锁关节脱位患者50例,采用切开复位,显露肩锁关节及喙突上表面,用克氏针开孔后形成锁骨远端内外侧及喙突骨通道,在体外用ULTRA-Braid缝线和3枚纽扣板作穿线操作制成可调V形悬吊固定装置,将纽扣板推送过骨通道重建喙锁韧带,逐步拉紧ULTRA-Braid线,维持肩锁关节对位。术前及术后3个月、12个月采用疼痛视觉模拟评分(visual analogue scale,VAS)及Constant-Murley肩关节功能评分标准进行功能评价。拍摄X线片,测量术前及术后3个月、12个月喙锁间距。结果术后X线片显示肩锁关节复位良好,VAS评分由术前(4.89±1.12)分下降至术后12个月的(0.31±0.44)分(P<0.05),Constant-Murley评分从术前(42.67±7.52)分提高至术后12个月的(92.26±7.84)分(P<0.05),术后12个月和术后3个月喙锁间距比较,差异无统计学意义(P>0.05)。结论三纽扣板可调悬吊固定技术复位精确,固定可靠,保留肩锁关节微动,不需要二次取内固定物,治疗肩锁关节脱位取得良好临床效果。Objective To explore the clinical efficacy of adjustable suspension fixation technique with three Endobutton plates for acute acromioclavicular joint dislocation.Methods From January 2018 to December 2019,50 patients with acute acromioclavicular dislocation of Rockwood typeⅢor higher were treated in our hospital.Open reduction was used to expose the acromioclavicular joint and the upper surface of the coracoid process.Bone channels at the internal and external sides of the distal clavicle and the coracoid process were formed with Kirschner wire.In vitro,an adjustable V-shaped suspension and fixation device was made with ULTRA-Braid sutures and three Endobutton plates by threading operations.The button plates were pushed through the bone channels to reconstruct the coracoclavicular ligament,and the ULTRA-Braid sutures were gradually tightened to maintain the position of the acromioclavicular joint.The function of shoulder joint was evaluated with visual analogue scale(VAS)and Constant-Murley scores preoperation,3 and 12 months after operation.X-ray films were taken to measure the coracoclavicular space before,3 and 12 months after operation.Results Postoperative X-ray showed good reduction of acromioclavicular joint.VAS score decreased from(4.89±1.12)to(0.31±0.44)12 months after operation(P<0.05),and the Constant-Murley score increased from(42.67±7.52)to(92.26±7.84)12 months after operation(P<0.05).There was no significant difference in coracoclavicular space between the data 12 months and3 months after operation(P>0.05).Conclusions The adjustable suspension fixation technique with three Endobutton plates has the advantages of accurate reduction,reliable and elastic fixation,no need to remove the fixation devices,and good clinical results in the treatment of acromioclavicular joint dislocation.

关 键 词：肩锁关节 肩脱位 关节脱位 肩关节 

分 类 号：R684.7[医药卫生—骨科学]