TightRope钢板与锁骨钩钢板联合喙肩韧带转位治疗Rockwood Ⅲ型肩锁关节脱位的疗效比较  

Comparison of TightRope system and hook plate fixation with coracoacromial ligament transfer in the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation

作　　者：储淼 周建刚[1] 蒋涛 鲍卫国 CHU Miao;ZHOU Jiangang;JIANG Tao;BAO Weiguo(Department of Orthopaedics,Yixing People’s Hospital,Jiangsu University,Yixing Jiangsu 214200,China)

机构地区：[1]宜兴市人民医院骨科,江苏宜兴214200

出　　处：《临床与病理杂志》2022年第9期2213-2220,共8页Journal of Clinical and Pathological Research

基　　金：江苏大学2021年度临床医学科技发展基金(JLY2021039)。

摘　　要：目的:比较TightRope钢板与锁骨钩钢板内固定联合喙肩韧带转位治疗RockwoodⅢ型肩锁关节脱位的短期疗效。方法:采取回顾性病例对照的方法,分析2015年1月至2019年12月宜兴市人民医院收治的60例RockwoodⅢ型肩锁关节脱位患者的临床资料,年龄42.4(21~60)岁。根据治疗方案,分为TightRope组与钩板韧带转位组,各30例。比较两组手术切口长度、手术时间、术中失血量、视觉模拟量表法(Visual Analog Scale,VAS)评分、Constant-Murley肩关节功能(ConstantMurley Shoulder Joint Function,CS)评分、术后肩锁关节功能恢复程度及并发症发生情况,并记录术后肩锁关节Karlsson疗效评分。结果:与钩板韧带转位组比较,TightRope组的平均手术时间较短[(57.30±5.27) min vs (63.30±5.49) min]、切口长度较短[(7.40±0.86) cm vs (10.13±1.07) cm]及术中失血量较少[(49.33±6.91) mL vs (64.53±9.83) mL],差异均有统计学意义(均P<0.001)。术后3个月TightRope组CS评分较钩钢板韧带转位组高[(91.07±3.69) vs (87.30±7.19)],差异有统计学意义(P<0.05)。术后6个月TightRope组VAS评分较钩钢板韧带转位组低[(0.73±0.45) vs (1.43±0.82),P<0.001]。两组Karlsson评分优良率分别为100%(30/30)、96.7%(29/30),差异无统计学意义(P>0.05)。结论:TightRope钢板或锁骨钩钢板联合喙肩韧带转位治疗RockwoodⅢ型肩锁关节脱位均可获得满意的短期疗效。与锁骨钩钢板联合喙肩韧带转位比较,TightRope在手术时间、手术切口长度及术中失血量各项中更占优势,且无需二次手术。在3个月时TighRope系统治疗的患者在活动度和肌力上可能恢复更好,6个月时疼痛感更轻。Objective: The aim of this study was to evaluate the short-term efficacy of TightRope system versus hook plate fixation with coracoacromial ligament transfer in the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation. Methods: From January 2015 to December 2019, 60 cases in Yixing People’s Hospital with Rockwood type Ⅲ acromioclavicular joint dislocation were retrospectively evaluated. The 60 cases, with an average age of 42.4 years(21 to 60 years), were divided into the TightRope group(n=30) and the Hook plate ligament transfer group(n=30) according to different treatment technique. The length of incision, procedure time, intraoperative blood loss, Visual Analog Scale(VAS) score, the Constant-Murley Shoulder Joint Function(CS) score, postoperative acromioclavicular recovery, and complications were compared between the 2 groups. The postoperative Karlsson efficacy score of the acromioclavicular joint was recorded. Results: The results showed that patients in the TightRope group had longer procedure time [(57.30±5.27) min vs(63.30±5.49) min], longer skin length [(7.40±0.86) cm vs(10.13±1.07) cm], less estimated blood loss [(49.33±6.91) mL vs(64.5±9.83) mL], and there were significant differences(all P<0.001). CS score at 3 months follow-up [(91.07±3.69) vs(87.30±7.19)] of the TightRope group was higher than that of the Hook plate ligament transfer group, and the difference was statistically significant(P<0.05). VAS score at 6 months follow-up of the TightRope group was lower than that of the Hook plate ligament transfer group [(0.73±0.45) vs(1.43±0.82), P<0.001]. The excellent rates of Karlsson score were 100%(30/30) and 96.7%(29/30), respectively, and the difference was not statistically significant(P>0.05). Conclusion: The treatment of Rockwood type Ⅲ acromioclavicular joint dislocation by TightRope system or hook plate fixation with coracoacromial ligament transfer can obtain satisfactory short-term efficacy. However, the TightRope system exhibited obvious advantages in terms of i

关 键 词：肩锁关节脱位 TIGHTROPE 锁骨钩钢板 喙肩韧带转位 

分 类 号：R687.3[医药卫生—骨科学]