关节镜下双Endobutton钛板固定治疗单侧Rockwood Ⅲ型急性肩锁关节脱位的临床疗效观察  

Clinical efficacy of arthroscopically assisted fixation with double Endobutton titanium plates in the treatment of acute acromioclavicular joint dislocation of unilateral Rockwood Ⅲ

作　　者：马立峰[1] 郭艾[1] 李智尧 李谷锋 于海洋 尹合勇 戴益科 刁乃成[1] 张京新 MA Li-feng;GUO Ai;LI Zhi-yao(Department of Orthopaedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050 [2]首都医科大学附属北京友谊医院康复科,北京100050

出　　处：《临床和实验医学杂志》2024年第12期1288-1292,共5页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金资助项目(编号:7222035)。

摘　　要：目的探讨关节镜辅助下双Endobutton钛板固定治疗患者单侧RockwoodⅢ型急性肩锁关节脱位的临床疗效。方法采用回顾性研究方法,选取2022年1月至2023年7月在首都医科大学附属北京友谊医院收治的单侧RackwoodⅢ型急性肩锁关节脱位的患者49例,根据手术方式的不同分为观察组(n=27)和对照组(n=22)。观察组接受关节镜辅助下肩锁关节脱位复位、双Endobutton钛板内固定手术治疗,对照组接受传统的切开复位锁骨钩钢板内固定手术治疗。所有患者进行门诊随访,记录术前、术后12周和末次随访时患者的视觉模拟疼痛评分(VAS)、美国加州大学洛杉矶分校肩关节系统评分(UCLA)以及肩关节正位X线上肩锁关节间距(ACD)和喙锁关节间距(CCD),并比较两种治疗方法的临床疗效。结果所有患者得到完整随访,随访时间为25.3~30.6周,平均(28.8±2.1)周。所有患者均未出现血管和神经损伤并发症。术后12周和末次随访,两组患者的VAS评分较术前有明显降低,UCLA肩关节评分均较术前升高,差异均有统计学意义(P<0.05);观察组和对照组术后12周和末次随访的VAS[(3.1±0.5)分vs.(3.3±0.6)分,(2.8±0.6)分vs.(2.7±0.8)分]、UCLA肩关节评分[(33.5±3.6)分vs.(33.7±3.2)分,(34.1±2.9)分vs.(34.7±2.6)分]比较,差异均无统计学意义(P>0.05)。术后12周和末次随访,两组患者的ACD和CCD均小于术前,差异均有统计学意义(P<0.05);两组间术后12周和末次随访的ACD[(5.2±1.8)分vs.(5.6±2.1)分,(5.1±1.7)分vs.(5.5±2.0)分]和CCD[(7.4±2.9)分vs.(7.2±2.5)分,(7.5±2.6)分vs.(7.1±2.6)分]比较,差异均无统计学意义(P>0.05)。末次随访观察组和对照组的优良率比较(81.6%vs.81.8%),差异无统计学意义(P>0.05)。结论关节镜下复位单侧RockwoodⅢ型急性肩锁关节脱位并使用双Endobutton钛板固定能够获得良好的治疗效果,与传统的切开复位钩钢板固定没有临床疗效的差异。Objective To investigate the efficacy of arthroscopically assisted fixation with double Endobutton titanium plates in the treatment of acute acromioclavicular joint dislocation of RockwoodⅢamong middle-aged patients.Methods A retrospective study was performed from January 2022 to July 2023.In Beijing Friendship Hospital,Capital Medical University,forty-nine patients who suffered acute acromioclavicular joint dislocation of unilateral RockwoodⅢwere enrolled and divided into two groups according to different surgical methods:control group and observation group.Twenty-seven patients in observation group were treated with arthroscopically assisted fixation with double Endobutton titanium plates.While twenty-two patients in control group were treated with open reduction and internal fixation of clavicle hook plate.All the patients were outpatient followed in outpatient.The visual analogue scale(VAS),the University of California Los Angles(UCLA),overlapping length of the acromioclavicular joint and the coracoclavicular distance(CCD)before surgery,at 12 weeks post surgery and the last follow-up of all patients were recorded and compared.Results All the patients were followed-up and the follow-up time was 25.3-30.6 weeks(average 28.8±2.1 weeks).There were no patients suffered vessels and nerves injury.At 12 weeks post surgery and the last follow-up,the VAS scores of the two groups were significant lower than those before surgery,the UCLA shoulder joint scores of the two groups were significantly higher than those before surgery,and the differences were statistically significant(P<0.05);there were no statistically significant differences in the VAS scores at 12 weeks and last follow-up in the observation group and the control group[(3.1±0.5)points vs.(3.3±0.6)points,(2.8±0.6)points vs.(2.7±0.8)points],the UCLA shoulder joint score[(33.5±3.6)points vs.(33.7±3.2)points,(34.1±2.9)points vs.(34.7±2.6)points](P>0.05).At 12 weeks post surgery and the last follow-up,the ACD and CCD of the two groups were smaller tha

关 键 词：肩锁关节脱位 关节镜 双Endobutton钛板固定 疼痛 功能康复 

分 类 号：R687.4[医药卫生—骨科学]