LARS人工韧带双环加强技术修复陈旧性肩锁关节损伤疗效研究  

Analysis of the effect of LARS artificial ligament double ring reinforcement technique in repairing chronic acromioclavicular joint injury

作　　者：王陶然 高嘉锴 贺翔 毕龙 WANG Tao-ran;GAO Jia-kai;HE Xiang;BI Long(Department of Orthopaedic Trauma,the First Affiliated Hospital of the Air Force Medical University,Xi′an 710032,China)

机构地区：[1]空军军医大学第一附属医院骨科,陕西西安710032

出　　处：《创伤与急危重病医学》2024年第3期168-172,共5页Trauma and Critical Care Medicine

摘　　要：目的探讨采用LARS人工韧带双环加强技术修复陈旧性肩锁关节损伤的临床疗效。方法选取自2023年1月至2024年1月空军军医大学第一附属医院收治的6例陈旧性肩锁关节损伤患者,采用LARS人工韧带双环加强技术进行喙锁韧带重建,恢复关节功能。记录手术时间、术中出血量及并发症发生情况。记录术前及术后末次随访影像学表现、喙锁间距,并评估术前及术后末次随访疼痛数字等级量表(NRS)评分、上肢功能障碍评定量表(DASH)评分、Constant评分。结果本组患者手术时间为(60.8±6.7)min,术中出血量为(51.7±23.4)ml,均在术后2周内获得伤口愈合。术后2周,患者开始功能锻炼,并定期随访,随访时间(7.8±2.4)个月(6~13个月)。本组患者术后均未发现神经血管损伤、感染、关节僵硬等并发症。1例患者出现挤压螺钉松动迹象,患者自觉螺钉处疼痛,术后6个月将挤压螺钉取出后恢复良好。术后末次随访,患者均感觉良好,无明显疼痛,X线影像未见肩锁关节脱位征象。末次随访时,喙锁间距较术前减小,NRS评分、DASH评分、Constant评分均较术前改善,差异有统计学意义(P<0.05)。结论LARS人工韧带双环加强技术修复陈旧性肩锁关节损伤可获得良好的中短期固定效果,但需要注意术中钻头方向、环扎方法等操作细节,以避免术后并发症的发生。Objective To investigate the clinical effect of LARS artificial ligament double ring reinforcement technique in repairing chronic acromioclavicular joint injury.Methods A total of 6 patients with chronic acromioclavicular joint injury admitted to the First Affiliated Hospital of the Air Force Medical University from January 2023 to January 2024 were selected,and the coracoclavicular ligament was reconstructed by LARS artificial ligament double ring reinforcement technique to restore shoulder function.Operation time,intraoperative blood loss and complications were recorded.Imaging examination and coracoclavicular distance were recorded at the preoperation and the last postoperative follow-up.The numerical rating scale(NRS),disabilities of the arm,shoulder and hand(DASH)score and Constant score were evaluated at the preoperation and the last postoperative follow-up.Results In this group,the operative time was(60.8±6.7)min,the intraoperative blood loss was(51.7±23.4)ml,and the wound healed within 2 weeks after the surgery.The patients began functional exercise at two weeks after the surgery,and all 6 cases were followed up regularly for(7.8±2.4)months(6-13 months).No complications such as neurovascular injury,infection and joint stiffness were found.One case showed signs of loosening of the squeeze screw.The patient felt pain on shoulder,and recovered well after the squeeze screw removed at 6 months after the surgery.At the last postoperative follow-up,all patients felt fine without obvious pain,and X-ray images showed no signs of acromioclavicular dislocation.At the last follow-up,the coracoclavicular distance decreased,while the NRS score,DASH score and Constant score were improved compared with those before the surgery,with statistical significance(P<0.05).Conclusion LARS artificial ligament double ring reinforcement technique for repairing chronic acromioclavicular joint injury can achieve good short-term and medium-term fixation effect.However,it is necessary to pay attention to the operational details such

关 键 词：LARS人工韧带 双环加强技术 肩锁关节损伤 陈旧性 

分 类 号：R687.4[医药卫生—骨科学]