肩锁关节脱位悬吊袢钢板固定术后再脱位

Re-dislocation after loop-plate suspension fixation of acromioclavicular dislocation

摘要:

[目的]分析关节镜下悬吊袢钢板治疗肩锁关节脱位术后再脱位的原因。[方法]采用关节镜下悬吊袢钢板技术治疗 36 例肩锁关节脱位患者，跟踪随访术后复位丢失例数并分析其具体原因。[结果] 所有患者均顺利完成手术，无严重并发症， 均获随访 6 个月以上。与术前相比，术后 6 个月 Constant-Murley 和 ASES 评分均显著增加(P＜0.05)；影像测量喙锁间距(cor- acoclavicular distance, CCD) 显著减小 (P＜0.05)。共 3 例术后再脱位，占 8.3%。再脱位原因，1 例为骨隧道不佳，1 例骨质疏松，1 例为过早负重。[结论] 肩关节镜下悬吊袢钢板治疗肩锁关节脱位术后仍可能发生再脱位，原因包括骨隧道不佳、骨质疏松、过早负重。

Abstract:

[Objective] To explore the causes of re-dislocation after arthroscopic loop-plate suspension fixation of the acromioclavicu- lar dislocation (ACD) . [Methods] A total of 36 patients received loop-plate suspension fixation for ACD in our department. The patients were followed up to determine the occurrence of postoperative re-dislocation, and analyze the specific reason. [Results] All patients had ACD reduced and fixed successfully without serious complications and were followed up for more than 6 months. Compared with those pre- operatively, the Constant-Murley and ASES scores significantly increased at 6 months after operation (P＜0.05) , the coracoclavicular dis- tance (CCD) measured on images decreased significantly (P＜0.05) . Re- dislocation was found in 3 patients, accounting for 8.3% . The causes of re- dislocation were poor bone tunnel positioning in 1 case, osteoporosis in 1 case, and premature weight bearing activity in 1 case. [Conclusion] Re-dislocation does still occur after loop-plate suspension fixation under shoulder arthroscopy for ACD. The reasons in- clude poor bone tunnel positioning, osteoporosis and premature weight bearing activity.