关节镜下袢钢板重建喙锁韧带治疗肩锁关节脱位  

Arthroscopy reconstruction of coracoclavicular ligament with loop plate for treatment of acromioclavicular joint dislocation

作　　者：刘磊 陆超峰 年坤党 方志豪 王靖 王卫忠 季斌 LIU Lei;LU Chao-feng;NIAN Kun-dang;FANG Zhi-hao;WANG Jing;WANG Wei-zhong;JI Bin(Graduate School of Bengbu Medical University,Bengbu,Anhui 233000,China;Dept of Orthopaedics,the First Hospital of Jiaxing City,Jiaxing,Zhejiang 314000,China)

机构地区：[1]蚌埠医科大学研究生院,安徽蚌埠233000 [2]嘉兴市第一医院骨科,浙江嘉兴314000 [3]浙江中医药大学研究生院,浙江杭州310000

出　　处：《临床骨科杂志》2024年第4期531-535,共5页Journal of Clinical Orthopaedics

基　　金：浙江省卫健委医药卫生科技计划项目(编号:2021KY1102)。

摘　　要：目的探讨关节镜下袢钢板重建喙锁韧带治疗肩锁关节脱位的疗效。方法采用关节镜下袢钢板重建喙锁韧带治疗15例肩锁关节脱位患者。记录术中出血量、手术时间、疼痛VAS评分、喙锁间距(CCD)和肩锁间距(ACD)、肩关节活动度。采用Constant-Murley评分评价肩关节功能恢复情况。结果患者均获得随访,时间5~47(19.93±12.05)个月。术中出血量30~100(50.67±21.12)ml,手术时间60~150(88.00±24.26)min。CCD、ACD末次随访时均短于术前(P<0.05)。末次随访时,疼痛VAS评分0~2分,Constant-Murley评分84~96(91.40±3.48)分,肩关节上举150°~180°(177.33°±7.99°)、后伸50°~60°(58.67°±3.52°)、内旋55°~70°(68.67°±3.99°)、外旋75°~90°(87.67°±4.17°)。结论关节镜下袢钢板重建喙锁韧带治疗肩锁关节脱位具有安全可靠、创伤小、患者可早期进行功能锻炼、肩关节功能恢复满意、无需二次手术取出的优点,能有效避免肩锁关节再次脱位及解决术后肩锁关节不稳定的问题。Objective To investigate the efficacy of reconstruction of coracoclavicular ligament with loop plate for treatment of acromioclavicular joint dislocation under arthroscopy.Methods The 15 cases of acromioclavicular joint dislocation were treated by reconstruction of coracoclavicular ligament with loop plate under arthroscopy.Intraoperative blood loss,operation time,pain VAS,coracoclavicular distance(CCD),acromioclavicular distance(ACD)and shoulder joint mobility were recorded.Constant-Murley score was used to evaluate the recovery of shoulder function.Results All patients were followed for 5~47(19.93±12.05)months.The blood loss during operation was 30~100(50.67±21.12)ml,and the operative time was 60~150(88.00±24.26)min.At the last follow-up time,CCD and ACD were shorter than those of preoperation(P<0.05).At the last follow-up,the pain VAS were 0~2 points,Constant-Murley scores of the shoulder joint were 84~96(91.40±3.48)points,and the ranges of shoulder joint mobility were 150°~180°(177.33°±7.99°)for lifting,50°~60°(58.67°±3.52°)for posterior extension,internal rotation with 55°~70°(68.67°±3.99°),and external rotation with 75°~90°(87.67°±4.17°).Conclusions Arthroscopic reconstruction of the coracoclavian ligament with loop plate for the treatment of acromioclavicular joint dislocation has the advantages of safety and reliability,less trauma,early functional exercise for patients,satisfactory recovery of shoulder joint function,and no need for secondary surgical removal.It can effectively avoid acromioclavicular joint re-dislocation and solve the problem of postoperative acromioclavicular joint instability.

关 键 词：肩锁关节脱位 喙锁韧带重建 袢钢板 关节镜检查 

分 类 号：R684.7[医药卫生—骨科学] R687.2[医药卫生—外科学] R687.4[医药卫生—临床医学]