喙锁韧带重建与锁骨钩钢板治疗RockwoodⅢ型肩锁关节脱位手术效果比较

摘要

目的 对比研究喙锁韧带重建与锁骨钩钢板治疗RockwoodⅢ型肩锁关节脱位手术效果.方法 回顾性分析2013年3月~2015年2月收治的36例RockwoodⅢ型创伤性肩锁关节脱位患者的临床资料,其中男性27例,女性9例;年龄19~32岁,平均24.7岁.18例行喙锁韧带带袢钢板(Endobutton)重建手术治疗(A组),18例行锁骨钩钢板手术治疗(B组).对两组患者手术时间、术后疼痛视觉模拟评分(visu-al analogue scale,VAS)及Constant-Murley肩关节功能评分方面进行比较分析.结果 两组患者平均手术时间分别为(59±4)min(A组)、(54±6)min(B组),两组间差异没有统计学意义(P=0.596);术后VAS分别为(1.8±0.7)分(A组)、(1.5±1.1)分(B组),差异无统计学意义(P=0.612);术后12周患者Constant-Murley肩关节功能评分分别为(91±3.7)分(A组)、(83±6.2)分(B组),B组患者的肩关节功能评分较A组低,两组间评分差异有统计学意义(P=0.027).结论 采取Endobutton悬吊重建喙锁韧带功能,固定肩锁关节脱位,更好地恢复了肩锁关节作为微动关节的生物力学及运动轨迹,未增加手术时间及导致创伤,肩关节功能恢复良好,较锁骨钩钢板是一种更理想的手术方式.%Objective To observe the effect of the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation with the reconstruction of the coracoclavicular ligament and the hook plate fixation.Methods Totally 36 cases of Rockwood type Ⅲacromioclavicular joint dislocation from Mar.2013 to Feb.2015 were retrospectively analyzed.Among them 27 were male and 9 were female ( age 19-32 years, mean 24.7 years ) . Eighteen cases ( Group A) accepted the surgery of coracoclavicular ligament reconstruction with the endobutton,and 18 cases ( Group B) accepted the surgery of hook plate fixation to reduct the dialocation of the acromioclavicular joint.The operation time,the VAS and the Constant-Murley score 12 weeks after surgery were analyzed and compared.Results The aver-age operation time was (59 ±4) minutes in Group A and (54 ±6) minutes in Group B without significant difference between the two groups;the VAS was ( 1.8 ±0.7 ) points in Group A and ( 1.5 ±1.1 ) points in Group B and the difference between the two groups was not significant;the Constant-Murley score was (91 ±3.7) points in Group A and (83 ±6.2)points in Group B and the difference between the two groups was significant(P=0.027).Conclu-sion Reduction of the acromioclavicular joint dislocation with the reconstruction of the coracoclavicular ligament u-sing the endbutton suspension can restore the biomechanics and moving track of the amphiarthrosis of acromioclavic-ular joint without increasing the operation time and the wound.It is an ideal surgery for its excellent recovery of the function of the shoulder.