双带袢纽扣钢板技术重建喙锁韧带治疗完全性肩锁关节脱位的疗效分析

摘要

目的 探讨双带袢纽扣钢板技术与AO锁骨钩钢板内固定治疗急性完全性肩关节脱位的疗效及预后.方法 纳入2015年3月至2017年1月在我院关节外科行手术治疗的52例急性肩锁关节脱位患者,按照随机数字表法分为纽扣钢板组(26例)和锁骨钩钢板组(26例),比较两组手术时间、住院费用、术后肩关节Constant评分、疼痛视觉模拟评分(visual analogue score,VAS)及并发症情况.结果 ①纽扣钢板组的手术时间高于锁骨钩钢板组,住院费用及疼痛消失时间低于锁骨钩钢板组,差异具有统计学意义(P＜0.05);②两组患者均坚持完成随访,无失访病例.两组组内比较,术前、术后3个月、1年、2年Constant评分及VAS评分均有统计学差异(P＜0.05),Constant评分逐渐升高,VAS评分逐渐降低.两组组间比较,Constant评分及VAS评分术前无明显差异(P＞0.05),而术后3个月、1年、2年纽扣钢板组Constant评分均明显高于锁骨钩钢板组(P＜0.05),术后3个月纽扣钢板组VAS评分明显低于锁骨钩钢板组(P＜0.05),但两组术后1年、2年的VAS评分无明显差异(P＞0.05).③两组术后肩关节复位情况、内固定物松动、移位及断裂等并发症发生率比较差异无统计学意义(P＞0.05).结论 双带袢纽扣钢板技术治疗急性完全性肩锁关节脱位疗效可靠,有利于早期肩关节功能恢复,且费用较低.%Objective To evaluate the efficacy and prognosis of double-belt button steel plate technique and AO clavicular hook plate internal fixation for acute complete acromioclavicular joint dislocation. Methods A total of 52 patients with acute complete acromioclavicular joint dislocation who underwent surgery in our hospital from March 2015 to January 2017 were randomly divided into a button plate group (26 cases) and a hook plate group (26 cases). Operation time, hospitalization cost, postoperative shoulder joint score, visual analogue scale (VAS) and complications were compared between the two groups. Results ①Operation time of the button plate group was longer than that of the hook plate group, and the hospitalization cost and pain disappearance time were lower and shorter than that of the hook plate group (P＜ 0.05).②The intra-group comparison showed there were significant differences in Constant score and VAS score among the points of pre-operation, 3- month, 1-year and 2-years after operation (P＜ 0.05). Constant score increased gradually and VAS score decreased gradually in each group. There were no significant differences in Constant score and VAS score between the two groups before operation (P＞0.05), but the Constant score in the button plate group was significantly higher than that of the hook plate group at 3 months, 1 year and 2 years after operation (P＜0.05), and the VAS score in the button plate group at 3 months after operation was significantly lower than that of the hook plate group (P＜0.05). There was no significant difference in VAS score between the two groups at 1 and 2 years after operation (P ＞ 0. 05). ③There were no significant differences in rates of postoperative shoulder joint reduction, internal fixation loosening, displacement and fracture between the two groups (P＞0.05). Conclusion The double-belt button plate technique is effective in the treatment of acute complete acromioclavicular joint dislocation, which is beneficial to the early recovery of shoulder function and more economical.