Endobutton重建喙锁韧带结合肩锁关节韧带修复增强肩锁关节稳定性的研究  

Study on Reconstruction of Coracoclavicular Ligament With Endobutton Plate Reconstruction of Coracoclavicular Ligament and Acromioclavicular Ligament Repair to Stabilize Acromioclavicular Joint

作　　者：丁凯[1] 丁文鸽[1] Ding Kai;Ding Wenge(Department of Orthopaedic Trauma,Changzhou First People’s Hospital,Changzhou 213000,China)

机构地区：[1]江苏省常州市第一人民医院创伤骨科,常州213000

出　　处：《中国微创外科杂志》2022年第8期614-620,共7页Chinese Journal of Minimally Invasive Surgery

基　　金：江苏省常州市卫健委青年人才科技项目(QN202102)。

摘　　要：目的评估Endobutton钢板重建喙锁韧带结合肩锁关节韧带修复能否增强肩锁关节稳定性。方法回顾性比较2016年1月~2019年12月Endobutton重建喙锁韧带结合肩锁关节韧带修复(A组)与单独Endobutton重建喙锁韧带(B组)各19例的临床参数,包括术前和术后1个月、12个月双侧喙锁间距离(X线测量)、Constant-Murley肩关节评分和美国加州大学(UCLA)肩关节评分,术后12个月双侧喙锁间距离的差值。结果38例随访12~18个月,(13.1±1.8)月。2组术后1个月和12个月Constant肩关节评分和UCLA肩关节评分较术前均明显上升,患侧喙锁间距离较术前明显减小,且A组均改善更多(P<0.05)。术后12个月A组患侧喙锁间距离与健侧相比无统计学差异[(4.8±0.1)mm vs.(4.8±0.1)mm,t=-1.837,P=0.083],而B组此距离仍明显大于健侧[(7.2±0.3)mm vs.(4.8±0.1)mm,t=-32.366,P=0.000]。结论Endobutton钢板重建喙锁韧带结合肩锁关节韧带修复比单纯Endobutton重建喙锁韧带更能增加术后肩锁关节的水平及垂直稳定性,减少术后复位丢失,基本恢复肩锁关节的正常位置,更符合肩锁关节的生理状态。Objective To evaluate whether Endobutton plate reconstruction of coracoclavicular ligament combined with acromioclavicular ligament repair can enhance the horizontal and vertical stability of the acromioclavicular joint.Methods A retrospective comparison of the clinical parameters of Endobutton reconstruction of coracoclavicular ligament combined with acromioclavicular ligament repair(group A,n=19)and Endobutton reconstruction of coracoclavicular ligament alone(group B,n=19)from January 2016 to December 2019 was carried out.The coracoclavicular distance,Constant-Murley shoulder joint score and UCLA shoulder joint score at preoperation and 1 month and 12 months after operation,and the difference between bilateral coracoclavicular distance 12 months after operation were measured.Results The 38 patients were followed up for 12-18 months(mean,13.1±1.8 months).The Constant shoulder score and UCLA shoulder score 1 and 12 months after surgery in the two groups were significantly increased as compared with those before surgery,and the coracoclavicular distance was significantly decreased as compared with that before surgery,with the improvement being more in the group A(P<0.05).At 12 months after surgery,the coracoclavicular distance in the affected side in the group A was not statistically different from that in the healthy side[(4.8±0.1)mm vs.(4.8±0.1)mm,t=-1.837,P=0.083],while the distance in the affected side in the group B was still significantly greater than that in the healthy side[(7.2±0.3)mm vs.(4.8±0.1)mm,t=-32.366,P=0.000].Conclusions Endobutton plate reconstruction of coracoclavicular ligament combined with acromioclavicular ligament repair can increase the horizontal and vertical stability of the acromioclavicular joint,reduce the loss of reduction after surgery,and basically restore the normal position of the acromioclavicular joint.It is more in line with the physiological state of the acromioclavicular joint.

关 键 词：肩锁关节脱位 水平稳定 复位丢失 肩锁关节韧带加强修复 

分 类 号：R687.4[医药卫生—骨科学]