一种改良双Endobutton袢钢板技术治疗RockwoodⅢ型肩锁关节脱位被引量：6

A modified closed-loop double-endobutton technique for the treatment of Rockwood type III acromioclavicular joint dislocation

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摘要目的双Endobutton袢钢板技术治疗肩锁关节脱位的效果得到了广泛肯定,但针对双Endobutton袢钢板技术的改良却从未停止。文中旨在探讨运用改良双Endobutton袢钢板锁定复位技术治疗RockwoodⅢ型肩锁关节脱位的临床疗效。方法回顾性分析2010年1月至2015年12月在西南医科大学附属中医医院骨伤科肩锁关节脱位患者60例。根据手术方式的不同,分为改良双Endobutton袢钢板技术(MCDT)组(有闭合回环结,n=30)和常规双Endobutton袢钢板技术(CCDT)组(无闭合回环结,n=30),对2组术中指标(手术时间、切口长度、术中出血量),以及术前和术后1年随访指标[Constant-Murley评分(CMS)、美国加州大学肩关节评分(UCLA)、美国肩肘外科协会评分(ASES)、牛津大学肩关节评分(OSS)以及CC-Dist值)]进行比较分析。结果 MCDT组手术时间、术中出血量优于CCDT组[(52.33±8.48)min vs(78.33±11.47)min,(79.17±9.75)m L vs(103.00±7.38)m L],差异有统计学意义(P<0.05)。MCDT组、CCDT组术后1年CMS、UCLA、ASES、OSS评分及CC-Dist值均优于术前;但2组间差异无统计学意义(P>0.05)。结论 2种方法均可取得较好的复位效果,但MCDT较CCDT复位固定更为简单、快捷,术中出血量更少。 Objective Double-endobutton technique , as a widely accepted strategy for the treatment of acromioclavicular joint dislocation （ ACD ） , is undergoing constant improvement .This study was to assess the clinical effect of a modified closed-loop double-endobutton technique （ CDT） in the fixation of Rockwood type Ⅲ ACD . Methods This retrospective study included 60 cases of Rockwood type Ⅲ ACD treated between January 2010 and December 2015, 30 by modified CDT （MCDT） and the other 30 by conventional CDT （CCDT）.We recorded and compared the operation time, incision length , intraoperative blood loss , pre-and post-opera-tive scores in the Constant-Murley Scale （ CMS ） , UCLA Shoulder Rating Scale （ SRS） , American Shoulder and Elbow Surgeons Rating Scale （ ARS） and Oxford Shoulder Score （ OSS）, and the vertical distance from the supraclavian to subcoracoid plane （ CC-Dist ） be-tween the two groups of patients . Results Compared with the CCDT group, the MCDT group showed a significantly shorter operation time （[78.33±11.47] vs [52.33±8.48] min, P〈0.05） and less intraoperative blood loss （[103.00±7.38] vs [79.17±9.75] mL, P〈0.05）.In comparison with the baseline, the patients of MCDT group achieved markedly improved scores at 12 months after surgery in CMS （46.60±2.09 vs 97.67±0.88, P〈0.05）, SRS （14.70±1.24 vs 32.17±1.21, P〈0.05）, ARS （44.23±2.40 vs 91.83±1.62, P〈0.05）, OSS （45.07±3.10 vs 15.80±1.81, P〈0.05）, and CC-Dist （[16.76±0.88] vs [7.57±0.73] mm, P〈0.05）. Conclusion MCDT, with the advantages of easier , tighter, and fas-ter reduction and fixation , is obviously superior to CCDT in the treatment of Rockwood type Ⅲ ACD .

作者张磊祁冀周鑫汪国友关钛元李义凯扶世杰

机构地区西南医科大学附属中医医院骨伤科南方医科大学中医药学院

出处《医学研究生学报》 CAS 北大核心 2017年第10期1079-1083,共5页 Journal of Medical Postgraduates

基金国家自然科学基金(81674095) 四川省教育厅科研项目(17ZB0472) 泸州市科技局科技计划项目(2016-176-13)

关键词肩锁关节脱位双Endobutton袢钢板锁定复位技术 Acromioclavicular dislocation Closed-loop double-endobutton Locking reduction technology

分类号 R648 [医药卫生—外科学]

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参考文献2

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