悬吊钛板双束重建喙锁韧带治疗Ⅲ型肩锁关节脱位
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南京中医药大学附属常州市中医医院

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南京中医药大学自然科学基金项目;常州市卫健委重大科技项目


Treatment of type Ⅲ acromioclavicular dislocation by double bundle reconstruction of coracoclavicular ligament with suspended titanium plate
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Changzhou Affiliated Hospital of Nanjing University of Traditional Chinese Medicine

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    摘要:

    目的:探讨Rigidloop悬吊钛板双束重建喙锁韧带治疗Rockwood Ⅲ型肩锁关节脱位的效果。方法:回顾性研究我院在2019年6月~2020年6月期间因Rockwood III型肩锁关节脱位接受手术治疗的48例患者,按术前医患沟通结果分为钩板组22例,重建组26例。记录比较两组围手术期、随访和影像指标。结果:两组患者的手术时间相似,差异无统计学意义(P>0.05),但重建组的切口总长度、术中失血量均小于钩板组(P<0.05),重建组住院时间短于钩板组(P<0.05)。在术后第1~3 d,重建组的VAS评分、CRP、IL-6水平较钩板组更低(P<0.05)。所有患者术后平均随访(22.2±2.5) 个月。两组患者恢复的完全负重活动时间相近,差异无统计学意义(P>0.05)。与术前相比,术后3月及末次随访时,两组患者的UCLA肩关节功能评分、肩关节ROM均增高(P<0.05)。在术后3月及末次随访时,重建组的UCLA肩关节功能评分、肩关节ROM均高于钩板组(P<0.05)。与手术前相比,术后3月及末次随访时,两组患者的CC与AC均减小(P<0.05)。在术后3月及末次随访时,两组间的CC与AC差异无统计学意义(P>0.05)。结论:相比于钩板组治疗Rockwood Ⅲ型肩锁关节脱位,重建组具有创伤小、术后恢复快、术后疼痛轻微、术后炎症水平低等优点,还可有效改善患者肩关节功能和肩关节活动度,提升肩锁关节复位效果。

    Abstract:

    Objective: To investigate the effect of double bundle reconstruction of coracoclavicular ligament with Rigidloop suspended titanium plate in the treatment of Rockwood Ⅲ acromioclavicular joint dislocation. Methods: A retrospective study was conducted on 48 patients with Rockwood III acromioclavicular joint dislocation who received surgical treatment in our hospital from June 2019 to June 2020. According to the results of preoperative communication between doctors and patients, they were divided into hook plate group (22 cases) and reconstruction group (26 cases). The perioperative, follow-up and imaging indexes of the two groups were recorded and compared. Results: The operation time of the two groups was similar, and the difference was not statistically significant (P>0.05), but the total length of incision and intraoperative blood loss in the reconstruction group were smaller than those in the hook plate group (P<0.05), and the hospital stay in the reconstruction group was shorter than that in the hook plate group (P<0.05). The VAS score, CRP and IL-6 levels in the reconstruction group were lower than those in the hook plate group (P<0.05) on the 1st to 3rd day after operation. All patients were followed up for an average of (22.2 ± 2.5) months. The recovery time of complete weight-bearing activity in the two groups was similar, and the difference was not statistically significant (P>0.05). Compared with preoperative, UCLA shoulder function score and shoulder ROM of patients in both groups were higher at 3 months and the last follow-up (P<0.05). At 3 months and the last follow-up, the UCLA shoulder function score and shoulder ROM in the reconstruction group were higher than those in the hook plate group (P<0.05). Compared with pre-operation, CC and AC of patients in both groups decreased at 3 months after operation and at the last follow-up (P<0.05). There was no significant difference in CC and AC between the two groups at 3 months and the last follow-up (P>0.05). Conclusion: Compared with the treatment of Rockwood III acromioclavicular joint dislocation with hook plate, the reconstruction group has the advantages of less trauma, rapid recovery, slight postoperative pain, and low postoperative inflammation level. It can also effectively improve the function and range of motion of the patients' shoulder joint, and improve the reduction effect of the acromioclavicular joint.

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  • 收稿日期:2022-10-17
  • 最后修改日期:2023-04-01
  • 录用日期:2023-05-06
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