镜下绕喙突悬吊固定肩锁关节脱位
作者:
作者简介:

李华德,副主任医师,博士学位,研究方向:骨关节与运动医学,(电话)0538-6230792,(电子信箱)lihuader@163.com

中图分类号:

R684.7

基金项目:

山东医药卫生科技发展计划项目(编号:202102080307)


Arthroscopic suspension fixation of acromioclavicular dislocation around coracoid
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    摘要:

    [目的] 比较关节镜下绕喙突悬吊与锁骨钩钢板固定治疗肩锁关节脱位的疗效。[方法] 回顾性分析 2018 年 1 月— 2021 年 6 月本院收治的急性闭合肩锁关节脱位 21 例患者的临床资料。根据医患沟通结果,21 例采用镜下悬吊固定,34 例采用钩板固定。比较两组临床及影像结果。[结果]两组均顺利完成手术,悬吊组在术中失血量 [(9.8±4.9) ml vs (35.9±11.3) ml, P< 0.05]、切口长度 [(4.1±0.6) cm vs (7.2±1.3) cm, P<0.05] 均显著优于钩板组 (P<0.05),尽管前者的手术时间显著长于后者 [(89.1± 18.7) min vs (61.7±12.5) min, P<0.05]。术后随时间推移,两组 VAS 评分显著减少 (P<0.05),ASES 评分、Constant-Murley 评分显著增加 (P<0.05)。术后 6 个月,悬吊组在 VAS 评分 [(1.1±0.7) vs (1.8±0.9), P<0.05]、ASES 评分 [(91.2±3.1) vs (80.1±4.8), P< 0.05] 和 Constant-Murley 评分 [(90.7±5.5) vs (80.2±7.4), P<0.05] 均显著优于钩板组。影像方面,两组术后 6 个月,两组 ACD、 CCD 均显著减小 (P<0.05);相应时间点,两组间 ACD 和 CCD 差异均无统计学意义 (P>0.05)。[结论] 与锁骨钩钢板相比,关节镜下绕喙突悬吊固定治疗肩锁关节脱位,可减少术后肩关节疼痛,更有利于肩关节功能恢复。

    Abstract:

    [Objective] To compare the clinical outcomes of arthroscopic suspension fixation around coracoid versus clavicular hook plate fixation for acromioclavicular dislocation. [Methods] A retrospective study was done on 55 patients who received surgical treatment for acute closed acromioclavicular dislocation in our hospitals from January 2018 to June 2021. According to the results of doctor-patient communication, 21 patients received arthroscopic suspension fixation around the coracoid (ASFC), while the other 34 patients underwent clavicular hook plate (CHP). The clinical and imaging documents were compared between the two groups. [Results] All the patients had op- eration performed successfully in both groups. The ASFC group proved significantly superior to the CHP group in terms of intraoperative blood loss [(9.8±4.9) ml vs (35.9±11.3) ml, P<0.05] and incision length [(4.1±0.6) cm vs (7.2±1.3) cm, P<0.05], although the former con- sumed significantly longer operation time than the latter [(89.1±18.7) min vs (61.7±12.5) min, P<0.05]. The VAS score for pain decreased significantly (P<0.05), while the ASES and Constant-Murley scores increased significantly over time in both groups (P<0.05). The ASFC group was significantly better than the CHP group in terms of VAS score [(1.1±0.7) vs (1.8±0.9), P<0.05], ASES score [(91.2±3.1) vs (80.1± 4.8), P<0.05] and Constant-Murley score [(90.7±5.5) vs (80.2±7.4), P<0.05] 6 months postoperatively. Radiographically, the acromioclavic- ular distance (ACD) and coracoclavicular distance (CCD) significantly decreased 6 months after surgery compared with those preoperatively in both groups (P<0.05), which proved not statistically significant between the two groups at any time points accordingly (P>0.05). [Conclu- sion] Compared with clavicular hook plate, the arthroscopic suspension fixation around coracoid for acromioclavicular dislocation reduces postoperative shoulder pain, and is more beneficial to the functional recovery of the shoulder.

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李华德,高胜一,辛培成,等. 镜下绕喙突悬吊固定肩锁关节脱位[J]. 中国矫形外科杂志, 2023, 31 (21): 1994-1997. DOI:10.3977/j. issn.1005-8478.2023.21.14.
LI Hua- de, GAO Sheng- yi, XIN Peicheng, et al. Arthroscopic suspension fixation of acromioclavicular dislocation around coracoid[J]. Orthopedic Journal of China , 2023, 31 (21): 1994-1997. DOI:10.3977/j. issn.1005-8478.2023.21.14.

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  • 收稿日期:2022-11-27
  • 最后修改日期:2023-04-11
  • 在线发布日期: 2023-11-21