依据术前CT预备钩钢板固定肩锁关节脱位△

Hook plate pre-shaped based on preoperative CT for acromioclavicular dislocation /

摘要:

[目的]探讨依据术前 CT 预备钩钢板治疗肩锁关节脱位的临床疗效。[方法]回顾性分析 2020 年 1 月—2022 年 12 月本院收治的 60 例急性闭合肩锁关节脱位患者的临床资料。根据医患沟通结果，30 例采用预备钩钢板治疗（钩板组），30 例采用袢钢板重建喙锁韧带治疗 （袢钢板组），比较两组临床及影像结果。[结果]钩板组手术时间 [(40.5±8.7) min vs (61.9±11.4) min, P＜0.001]、切口长度 [(6.3±1.6) cm vs (7.50±2.2) cm, P＜0.001]、术中出血量 [(52.6±14.8) mL vs (75.4±13.2) mL, P＜0.001] 均显著少于袢钢板组。与术后 3 个月相比，末次随访时两组患者 VAS、Constant 评分及肩前屈上举活动度均无显著变化（P＜0.05）。相应时间点，两组间 VAS、Constant 评分及肩前屈上举活动度的差异均无统计学意义（P＞0.05）。影像方面，与术前相比，术后 6 个月两组肩锁间距（acromioclavicular distance, AC）、喙锁间距（coracoclavicular distance, CC）均显著减小（P＜0.05），相应时间点，两组间 AC、CC 比较的差异均无统计学意义（P＞0.05）。[结论]术前 CT 预备钩钢板治疗肩锁关节脱位操作简单，费用低廉，临床疗效满意。

Abstract:

[Objective] To investigate the clinical effect of the hook plate pre-shaped based on preoperative CT for internal fixation of acromioclavicular dislocation. [Methods] A retrospective study was conducted on 60 patients who had acute closed acromioclavicular dislocation treated surgically in our hospital from January 2020 to December 2022. According to the doctor-patient communication, 30 patients were treated with the pre-shaped hook plate (HP group), while other 30 patients were treated with loop plate to reconstruct coracoclavicular ligament (LP group). The clinical and imaging documents of the two groups were compared. [Results] The HP group proved significantly superior to the LP group in terms of operation time [(40.5±8.7) min vs (61.9±11.4) min, P＜0.001), incision length [(6.3±1.6) cm vs (7.5±2.2) cm, P＜0.001] and intraoperative blood loss [(52.6±14.8) mL vs (75.4±13.2) mL, P＜0.001]. Compared with those 3 months after surgery, the VAS for pain, Constant score and shoulder forward flexion and upward range of motion (ROM) remained unchanged at the latest follow-up in both groups (P＞0.05), which were not significantly different between the two groups at any corresponding time points (P＞0.05). As for imaging, the acromioclavicular distance (ACD) and coracoclavicular distance (CCD) in both groups decreased significantly at 6 months after surgery compared with those preoperatively (P＜0.05), whereas which were not significantly different between the two groups at any time points accordingly (P＞0.05). [Conclusion] This pre-shaped hook plate based on preoperative CT for the treatment of acromioclavicular dislocation is simple and inexpensive, achieves satisfactory clinical consequence.