临床外科杂志 ›› 2020, Vol. 28 ›› Issue (11): 1055-1058.doi: 10.3969/j.issn.1005-6483.2020.11.017

• 论著 • 上一篇    下一篇

喙锁韧带重建与锁骨钩钢板治疗急性Rockwood Ⅴ型肩锁关节脱位的对比研究

  

  1. 广东省深圳市人民医院/暨南大学第二临床医学院/南方科技大学第一附属医院骨关节科
  • 出版日期:2020-11-20 发布日期:2020-11-20

A retrospectivecomparative study of coracoclavicular ligamentreconstruction and hook plate for acute Rockwood type Ⅴ acromioclavicular joint dislocation

  • Online:2020-11-20 Published:2020-11-20

摘要: 目的:比较喙锁韧带重建技术与锁骨钩钢板技术治疗急性Rockwood Ⅴ型肩锁关节脱位的临床疗效。方法:2016年1月~2019年1月,我科连续收治并获得随访的急性Rockwood Ⅴ型肩锁关节脱位病人33例,根据治疗方法分为两组,重建组15例,采用LARS人工韧带重建喙锁韧带;钩钢板组18例,采用锁骨钩钢板切开复位内固定。术后第1、3、6、12个月复查X线片评估是否存在复位丢失,并采用视觉模拟评分(VAS)及ConstantMurley评分,评估病人疼痛程度及肩关节功能。结果:两组病人术后切口均甲级愈合,未出现感染、神经、血管损伤等早期并发症。钩钢板组病人于术后12个月左右取出内固定物。术后1个月韧带重建组病人伤侧肩关节VAS评分(2.40±0.91)低于钩钢板组(3.61±1.58),差异有统计学意义(P<0.05),韧带重建组病人伤侧肩关节ConstantMurley功能评分(68.07±8.84)高于钩钢板组(58.78±7.92),差异有统计学意义(P<0.05);术后第3、6、12个月,韧带重建组病人伤侧肩关节VAS评分分别为1.93±0.80、0.87±0.74和0.53±0.64,钩钢板组分别为2.56±1.10、1.17±0.99和60.67±0.69,两组比较差异无统计学意义(P>0.05),韧带重建组病人伤侧肩关节ConstantMurley功能评分稍高于钩钢板组(68.07±8.84比58.78±7.92,80.93±6.35比76.61±6.73,90.80±3.10比87.72±5.39,93.13±2.80比91.39±4.78),差异无统计学意义(P>0.05)。结论:喙锁韧带重建技术与钩钢板技术治疗急性Rockwood Ⅴ型肩锁关节脱位的临床疗效均满意,但喙锁韧带重建术后恢复快、无需再次手术取出内固定物。

关键词: 肩锁关节脱位, 喙锁韧带, 人工韧带, 锁骨钩钢板

Abstract: Objective:To analyze and compare the clinical efficacy of coracoclavicular ligament reconstruction technique and hook plate technique in the treatment of acute Rockwood Ⅴ acromioclavicular joint dislocation.Methods:Clinical date of 33 patients with acute Rockwood Ⅴ acromioclavicular joint dislocation who were admitted and followed up inour department from January 2016 to January 2019 were retrospectively analyzed. In 15 cases, LARS artificial ligament was used to reconstruct coracoclavicular ligament (reconstruction group), and in 18 cases, clavicular hook plate was used for open reduction and internal fixation (hook plate group). Xray films were reviewed at the 1st, 3rd, 6th and 12th months after the operation to assess whether there was reduction loss. VAS score and ConstantMurley score were used to assess the patients’ pain degree and shoulderfunction.Results:All the incisions in the two groups were grade a healed, and there were no early complications such as infection, nerve and vascular injury. In the hook plate group, the internal fixation was removed about 12 months after the operation.VAS score of injured shoulder in the ligament reconstruction group was lower than that in the hook plate group [(2.40±0.91)vs (3.61±1.58)],with statistically significant difference (P<0.05).The ConstantMurley function score of injured shoulder in the ligament reconstruction group was higher than that in the hook plate group [(68.07±8.84)vs(58.78±7.92)], with statistically significant difference (P<0.05). At 3,6 and 12 months after surgery, VAS score of injured shoulder the ligament reconstruction group was slightly lowerthan that in the hook plate group ,(1.93±0.80)vs(2.56±1.10), (0.87±0.74)vs(1.17±0.99), (0.53±0.64)vs(0.67±0.69), but the difference was not statistically significant (P>0.05). The ConstantMurley function score of injured shoulder in the ligament reconstruction group was slightly higher than that in the hook plate group, (68.07±8.84)vs(58.78±7.92), (80.93±6.35)vs(76.61±6.73), (90.80±3.10)vs(87.72±5.39),(93.13±2.80)vs(91.39±4.78), but the difference was not statistically significant (P>0.05).Conclusion:Both coracoclavicular ligament reconstruction technique and hook plate technique are satisfactory in the treatment of acute Rockwood Ⅴ acromioclavicular joint dislocation.However, the reconstruction of the coracoclavicular ligament has the advantages of quick recovery after operation and no need to remove the internal fixation again.

Key words: acromioclavicular joint dislocation, coracoclavicular ligament, artificial ligament, clavicle hook plate

Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 张进祥;潘文明. 多学科团队模式在创伤救治中的作用[J]. 临床外科杂志, 2018, 26(8): 572 .
[2] 李振, 苏宏, 吴冬等. 环周预切开内镜下黏膜切除术与内镜黏膜下剥离术治疗大肠侧向发育型肿瘤的效果分析[J]. 临床外科杂志, 2018, 26(12): 973 -975 .
[3] 刘征, 杨为民. 泌尿系感染致病菌耐药的危险因素分析[J]. 临床外科杂志, 2019, 27(2): 107 -108 .
[4] 梁波. 陈旧性冈上肌肌腱撕裂合并功能障碍病人的肩关节镜修复及松解治疗[J]. 临床外科杂志, 2019, 27(4): 316 -319 .
[5] 徐亮, 刘凤英, 丁倩. Caprini评分、D-二聚体、纤维蛋白原水平在骨折后下肢深静脉血栓病人中的变化及其临床意义[J]. 临床外科杂志, 2019, 27(4): 328 -330 .
[6] 杨志林 吴岷翰 霍景山. 异物致阑尾穿孔并脓肿形成一例[J]. 临床外科杂志, 2020, 28(7): 661 -662 .
[7] 张云龙 余伟民 程帆 黄晨 阮远 饶婷 李成龙. 腹腔镜肾部分切除术治疗肾脏上组肾盏颈闭锁的疗效分析[J]. 临床外科杂志, 2020, 28(8): 781 -783 .
[8] 张加桥 余虓 胡恒龙 卢俊霖 许楚瓯 杨为民. 肾积水程度与经皮肾镜碎石取石术术后出血的关系[J]. 临床外科杂志, 2020, 28(9): 878 -881 .
[9] 王勇 陶治鹤 田少斌. 手术与放疗间隔与新发胶质母细胞瘤病人肿瘤增长及预后的相关性[J]. 临床外科杂志, 2020, 28(10): 934 -937 .
[10] 张和栋, 彭龙开, 谢续标. 中美人体器官移植医师培训比较[J]. 临床外科杂志, 2020, 28(11): 1000 -1002 .