双切口闭合复位TightRope技术治疗Rockwood Ⅲ~Ⅴ型急性肩锁关节脱位  

Double incision closed reduction technique of TightRope for the treatment of Rockwood type Ⅲ to Ⅴ acuteacromiocla joint dislocation

作　　者：胡海洋 巨积辉 张广亮[1] 张笑 金光哲 顾诚 Hu Haiyang;Ju Jihui;Zhang Guangliang;Zhang Xiao;Jin Guangzhe;Gu Cheng(Department of Hand Surgery,Suzhou Ruihua Orthopedic Hospital,Suzhou 215104,China;Medical College of Yangzhou University,Yangzhou 225009,China)

机构地区：[1]苏州瑞华骨科医院手外科,苏州1215104 [2]扬州大学医学院,扬州225009

出　　处：《中华手外科杂志》2023年第5期399-402,共4页Chinese Journal of Hand Surgery

基　　金：苏州市重点病种诊疗技术专项项目(LCZX202026);苏州市重点学科(SZXK202127)。

摘　　要：目的报告使用双切口闭合复位TightRope技术治疗Rockwood Ⅲ~Ⅴ型急性肩锁关节脱位的早期临床疗效。方法自2019年1月至2021年12月, 我们使用双切口闭合复位TightRope技术治疗急性肩锁关节脱位患者31例, Rockwood分型:Ⅲ型5例, Ⅳ型17例, Ⅴ型9例。对患者术前、术后6个月视觉模拟评分(visual analogue score, VAS)、Constant-Murley评分(CMS)进行比较。结果术后所有患者均获得随访, 时间为6~14个月, 平均7.94个月, 切口均Ⅰ期愈合, 无喙突及锁骨骨折、无袢钢板脱落等并发症。术前VAS为(6.29±0.46)分、术后6个月(1.19±0.40)分, 采用Wilcoxon signed-rank检验, 两组比较差异具有统计学意义(P=0.001)。术前CMS为(39.65±2.54)分、术后6个月(91.45±1.84)分, 采用配对t检验, 两组比较差异具有统计学意义(P<0.001)。结论采用双切口闭合复位TightRope技术治疗Rockwood Ⅲ~Ⅴ型急性肩锁关节脱位, 术后肩关节功能恢复满意, 值得临床推广。Objective To report the early clinical efficacy of double incision closed reduction technique of TightRope for the treatment of Rockwood type Ⅲto Ⅴ acute acromioclavicular joint dislocation.Methods From January 2019 to December 2021,31 patients with acute acromioclavicular joint dislocation were treated by double incision closed reduction technique of TightRope.According to the Rockwood classification,there were 5 cases of type Ⅲ,17 cases of type IV and 9 cases of type V.The visual analogue score(VAS)and Constant-Murley score(CMS)were compared before and 6 months after the operation.Results All the patients were fllow-up for 6 to 14 months,with an average of 7.94 months.All the incisions achieved primary healing,without complications such as coracoid process and clavicle fractures,and without loop plate detachment.The preoperative VAS was(6.29±0.46)points and 6 months afer the operation the score was(1.19±0.40)points.Using Wilcoxon signed rank test,the difference between the two groups was statistically significant(P=0.001).The preoperative CMS was(39.65±2.54)points and 6 months after the operation the score was(91.45±1.84)points.Using paired t-test,the difference between the two groups was statistically significant(P<0.001).Conclusion The treatment of Rockwood type Ⅲto V acute acromioclavicular joint dislocation with double incision closed reduction technique of TightRope can achieve satisfactory functional recovery of the shoulder joint,which is worthy of clinical promotion.

关 键 词：肩锁关节 脱位 喙锁韧带 Rockwood分型 

分 类 号：R687.4[医药卫生—骨科学]