镜下喙突免钻孔喙锁韧带重建术
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南昌市洪都中医院运动医学科

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Reconstruction of coracoclavicular ligament with coracoid tunnel-free under arthroscope
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Nanchang Hongdu Hospital of Traditional Chinese Medicine

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    摘要:

    [目的]介绍镜下喙突免钻孔喙锁韧带重建术的手术技术和初步临床结果。[方法] 2020年4月至2021年9月,对18例肩锁关节脱位(Rockwood Ⅲ-V)患者采用关节镜监视下喙突免钻孔喙锁韧带重建术进行治疗。首先于锁骨外侧占其全长16%及25%位置处建立锁骨双隧道。利用引线将TightRope钢板的高强线绕过喙突基底部,并从锁骨双隧道穿出。内侧隧道放置纽扣板,外侧隧道放置可调板。然后收紧高强线使袢钢板与锁骨紧密贴合,逐渐复位肩锁关节,最后再次打结固定。[结果] 所有患者均顺利完成手术,无严重并发症,随访5-22个月。与术前相比,末次随访时肩关节VAS评分,ASES评分和Constant评分均显著改善(P <0.05)。[结论] 关节镜下喙突免钻孔喙锁韧带重建术治疗肩锁关节脱位能够取得良好临床疗效。

    Abstract:

    [Objective] To introduce the surgical technique and preliminary clinical results of reconstruction of coracoclavicular ligament with coracoid tunnel-free under arthroscope. [Methods] From april 2020 to September 2021, a total of 18 patients with acromioclavicular joint dislocation(Rockwood Ⅲ-V)were treated with arthroscopic reconstruction of coracoclavicular ligament with coracoid tunnel-free technique. Fistly,a double clavicular tunnel was established at the position where the lateral clavicle accounted for 16% and 25% of its total length, The high-strength wire of tightrope steel plate is used to bypass the bottom of coracoid and pass through the clavicular double tunnel by lead wire.The button plate is placed in the inner tunnel and the adjustable plate is placed in the outer tunnel.Then tighten the high-strength wire to make the steel plate closely fit with the clavicle, gradually reseted the acromioclavicular joint.Finally, tied and fixed again. [Results] All patients had surgical procedures performed successfully without serious complications, and were followed up for 5-22 months. The ASES, VAS and Constant scores significantly improved at the latest follow up compared with those before operation (P<0.05). [Conclusion] Arthroscopic reconstruction of coracoclavicular ligament with coracoid tunnel-free technique could achieve satisfactory clinical outcomes for acromioclavicular joint dislocation.

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  • 收稿日期:2022-03-25
  • 最后修改日期:2022-07-02
  • 录用日期:2022-10-19
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