Endobutton改良法治疗肩锁关节脱位术后对复位丢失肩关节功能及远期风险的影响

摘要

目的:探讨Endobutton改良技术治疗肩锁关节脱位术后对复位丢失肩关节功能及远期风险的影响,以期为肩锁关节脱位的治疗提供依据.方法:选取肩锁关节脱位患者46例为研究对象,随机单盲取法将其分为研究组与对照组.对照组22例采用Endobutton技术治疗,研究组24例采用Endobutton改良法技术治疗.观察两组患者手术及住院情况,并随访1年,观察两组患者术后不同时间复位丢失、以及Constan-M urley评分评定情况.结果:两组患者均顺利完成手术,研究组手术时间及出血量低于对照组(P<0.05);两组住院时间对比,差异无统计学意义.随访1年未见失访患者,两组术后6、12个月复位丢失与术后3 d及组间对比,差异无统计学意义;6、12个月复位丢失量组间对比,差异无统计学意义;两组术后不同时间Constan-M urley评分各指标及总分均高于术前同指标(P<0.05);两组术后同期同Constan-Murley评分指标及总分对比,差异均无统计学意义,研究组发生术后并发症2例低于对照组7例(P<0.05).结论:改良Endobutton钢板内固定治疗肩锁关节脱位可达到Endobutton钢板内固定治疗效果,且可简化操作程序、减少手术时间、减少术中出血量,避免Ethiboad缝线老化、弹性下降及疲劳性断裂等风险.%Objective:To investigate the effect of Endobutton on the loss of shoulder joint function and long-term risk after the treatment of dislocation of the shoulder joint dislocation .Methods :Select shoulder lock joint dislo-cation were 46 cases as the object of study ,a randomized ,single blind extraction method was divided into the study group and the control group ,22 cases in the control group using the endobutton technique in the treatment ,the study group using endobutton modified technique in the treatment ,observation of two groups of patients with opera-tion and hospitalization .After 1 years of follow-up ,two groups of patients were observed at different time after sur-gery ,and the Constan-Murley score was assessed at different time .Results :Two groups of patients were successfully completed surgery ,the study group operation time and blood loss were lower than the control group (P<0 .05) , two groups of hospital stay ,the difference was not statistically significant .Followed up 1 year no loss to follow-up patients .After operation in two groups of 6 and 12 months ,the reduction loss and postoperative 3d and inter group comparison ,the difference was not statistically significant ,6 and 12 months ,reduction and loss amount between groups contrast ,there was no significant difference in and after operation in two groups at different time Constan-Murley score of each index and total score were higher than preoperative with index (P< 0 .05) ,after operation in the two groups over the same period with Constan-Murley score index and total score comparison ,the difference was not statistically significant ,the study group occurred postoperative complications in 2 cases lower than that of the control group (n= 7) (P< 0 .05) .Conclusion:Improved endobutton plate internal fixation in the treatment of shoul-der lock joint dislocation endobutton plate fixation for the treatment effect can be achieved and can simplify operating procedures ,reduce the operation time ,reduce the amount of bleeding during the operation ,to avoid the risk of su-ture Ethiboad ,decreased elasticity and fatigue fracture aging .