摘要
目的 探讨同种异体肌腱结合带线锚钉重建喙锁韧带治疗急性肩锁关节脱位的手术治疗方法和临床疗效.方法 对2009年1月至2012年5月收治的17例急性肩锁关节脱位病例进行回顾性研究,按照Rockwood分型：Ⅲ型10例,Ⅳ型2例,Ⅴ型5例.术后根据Constant-Murley评分及影像学评估临床疗效.结果 所有患者均获得12～26个月的随访,平均16.3个月.所有患者恢复正常工作生活.末次随访时患侧Constant-Murley评分平均为（93.70±1.85）分,健侧平均为（95.80±1.18）分,两者差异无统计学意义（t=0.640,P=0.43）.术前测量肩关节正位片喙锁间隙距离平均为（14.02±1.98）mm,术后即刻为（8.32±0.46）mm,末次随访时为（8.49±0.48）mm.术后即刻和末次随访时喙锁间隙距离与术前比较差异有统计学意义（t=12.984,P=0.000）,术后即刻与末次随访时喙锁间隙距离差异无统计学意义（t=-5.821,P=0.24）.无感染、血管神经损伤及内固定失效等并发症.结论 同种异体肌腱结合带线锚钉重建喙锁韧带治疗急性肩锁关节脱位临床疗效良好.
Objective To investigate the surgical techniques and clinical outcomes of treating acute acromioclavicular（AC） joint dislocations with coracoclavicular （CC） ligament reconstruction using allogeneic tendon graft and suture anchors.Methods From January 2009 to May 2012,17 patients with acute AC joint dislocation were treated in our department using allogeneic tendon graft reconstruction of the CC ligament combined with suture anchors.According to Rockwood classification,there were 10 cases of type Ⅲ,2 cases of type Ⅳ,and 5 cases of type Ⅴ.The Constant-Murley score and radiographs were used to assess surgical outcomes.Results All the patients were follow-up for 12 to 26 months,with an average of 16.3 months.All patients maintained their previous jobs and normal daily activities of living.The mean Constant-Murley score at the last follow-up was （93.70 ± 1.85） points on the injured side and （95.80 ± 1.18） points on the uninjured contralateral side.There was no statistically significant difference（t =0.640,P =0.43）.The mean CC distance measured on the anteroposterior shoulder X-rays was （14.02 ± 1.98） mm before the surgery,（8.32 ± 0.46） mm immediately after the surgery and （8.49 ± 0.48） mm at last follow-up.The preoperative and postoperative CC distances were significantly different （t =12.984,P =0.000）,while no significant difference was observed between immediate postoperative CC distance and CC distance at last follow-up （t =-5.821,P =0.24）.There were no wound infection,neurovascular injury,implant loosening or other severe complications.Conclusion CC ligament reconstruction using suture anchors and allogenetic tendon graft in acute complete AC dislocation is a reliable technique for restoring stability to the AC joint.
出处
《中华手外科杂志》
CSCD
北大核心
2014年第4期265-267,共3页
Chinese Journal of Hand Surgery
关键词
脱位
缝合技术
肩锁关节
喙锁韧带
重建
Dislocations
Suture technique
Acromioclavicular joint
Coracoclavicular ligament
Reconstruction
