缝线锚钉与袢钢板固定肩锁关节脱位的疗效比较

Suture anchor versus loop plate used in coracoclavicular ligament reconstruction for acromioclavicular dislocation

摘要:

［目的］ 比较缝线锚钉与袢钢板治疗肩锁关节脱位的疗效。［方法］ 回顾性分析 TossyⅢ型肩锁关节脱位行喙锁韧带重建治疗的 65 例患者的临床资料。其中，32 例采用锚钉重建，33 例采用袢钢板重建。对比两组患者的临床及影像学结果。 ［结果］ 锚钉组手术时间、出血量、切口总长度均显著优于袢钢板组 （P<0.05）。与术前相比，术后 2 年两组 VAS 评分显著降低 （P<0.05），而 Constant-Murley 评分显著增加 （P<0.05）；相应时间点，两组间上述评分差异均无统计学意义 （P>0.05）。影像方面，术后两组肩锁间距和喙锁间距均较术前显著减小 （P<0.05）。术后 2 年锚钉组的喙锁间距显著大于袢钢板组 （P< 0.05）。［结论］缝线锚钉与袢钢板喙锁韧带重建均能缓解肩关节疼痛、恢复肩关节功能。缝线锚钉重建对喙锁间距的保持不及袢钢板重建，但其创伤较小，用时较短。

Abstract:

[Objective] To compare the clinical outcomes of suture anchor versus loop plate used in coracoclavicular reconstruction for acromioclavicular dislocation. [Methods] A retrospective study was conducted on 65 patients who underwent coracoclavicular reconstruc- tion for Tossy type Ⅲ acromioclavicular dislocation. Of them, 32 patients had suture anchor used, while the remaining 33 patients had loop plate used for the reconstruction. The clinical and imaging results were compared between two groups. [Results] The anchor group proved significantly superior to the plate group in terms of operation time, blood loss and incision length (P＜0.05) . The VAS score significantly de- creased, whereas the Constant-Murley score significantly increased in both groups at 2 years postoperatively compared with those before op- eration (P＜0.05) , however there was no significant difference in abovesaid scores between two groups at any matching time points (P＞ 0.05) . Radiographically, the acromioclavicular distance and coracoclavicular distance significantly decreased in both groups postoperative- ly compared with those preoperatively (P＜0.05) . The anchor group had significantly greater coracoclavicular distance than the plate group at 2 years postoperatively (P＜0.05) . [Conclusions] Both suture anchor and loop plate used for coracoclavicaular reconstruction do alleviate shoulder pain and restore shoulder joint function. The suture anchor reconstruction is inferior to the loop plate in maintaining the coracocla- vicular distance, despite of advantages of less trauma and less operation time consumed.