摘要
目的:比较双Endobutton带袢钢板和锁骨钩钢板治疗肩锁关节脱位的疗效和安全性。方法:纳入2011年6月至2015年2月入院的46例行手术治疗的RockwoodⅢ～Ⅴ型肩锁关节脱位患者,完成随访37例(锁骨钩钢板治疗18例、双Endobutton袢钢板治疗19例),随访3年。对随访患者采用Constant-Murley评分和UCLA肩关节评分标准进行肩关节功能评定,记录中期并发症,并拍摄双肩关节X线片进行影像学评估。结果:术后3 d、3月Endobutton组Constant-Murley评分、UCLA评分较钩钢板组明显增高(P <0.05),而术后1年和最后一次随访两种术式的Constant-Murley评分、UCLA评分差异无统计学意义(P> 0.05)。钩钢板组术后有8例患者存在不同程度的肩部疼痛或不适,疼痛发生率较Endobutton组(2例)高(χ2=5.3917,P=0.020),但取出钢板后仅有1例遗留长期疼痛,Endobutton组有2例术后发生长期疼痛;中期随访Endobutton组总的并发症发生率相对较高(31.6%vs 16.7%),但两组比较无统计学意义(χ2=1.1166,P=0.291)。钩钢板组在术后和取钢板前较双Endobutton组喙锁间距窄(P <0.05),但末次随访时两组喙锁间距差异无统计学意义(t=0.4056, P=0.6875)。结论:双Endobutton袢钢板和锁骨钩钢板治疗RockwoodⅢ～Ⅴ型肩锁关节脱位均可获得满意疗效,总的中期并发症发生率相当,但双Endobutton袢钢板术式恢复更快,是一种安全实用的手术方法。
Objective:To evaluate the effect and safety of double endobutton technique for acromioclavicular joint dislocation compared with clavicular hook plate fixation.Methods:A total of46patients with Rockwood typeⅢ~Ⅴacromioclavicular joint dislocation,who underwent a surgery from June2011to February2015in our hospital,were enrolled.A36-month follow-up was completed in37of these patients,including18patients treated with clavicular hook plate fixation and19patients treated with double endobutton technique.Constant-Murley and UCLA scores were used to assess the shoulder joint function of patients followed up.Mid-term complications were recorded.X-ray of both shoulder joints was used for imaging evaluation.Results:At3days and3months after surgery,the endobutton group had significantly higher Constant-Murley and UCLA scores than the hook plate group(P<0.05).However,there were no significant differences in Constant-Murley and UCLA scores between the endobutton group and the hook plate group at1year postoperatively and the last follow-up(P>0.05).The hook plate group had a significantly higher incidence of shoulder pain or discomfort after surgery than the endobutton group(8cases vs2cases,χ^2=5.3917,P=0.020),but the pain disappeared in most patients after the plates were removed.The incidence of total mid-term complications was higher in the endobutton group than in the hook plate group(31.6%vs16.7%,χ^2=1.1166,P=0.291).The coracoclavicular distance was significantly shorter in the hook plate group than in the endobutton group after surgery and before plate removal(P<0.05),but was not significantly different between the two groups at the last follow-up(t=0.4056,P=0.6875).Conclusion:Both double endobutton technique and clavicular hook plate fixation have a satisfactory effect in the treatment of Rockwood typeⅢ~Ⅴacromioclavicular joint dislocation,with comparable incidence of total mid-term complications.However,double endobutton technique is a safe,useful way to treat acromioclavicular joint dislocation as the patients treated with this technique have faster recovery postoperatively.
作者
窦畅
姚豹
吴永乐
李佳鸿
杨林
彭超
聂海
DOU Chang;YAO Bao;WU Yongle;LI Jiahong;YANG Lin;PENG Chao;NIE Hai(Department of Orthopedic Surgery(East Campus),Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu610101,Sichuan Province,China;Department of Orthopedics,University-Town Hospital of Chongqing Medical University;Department of Orthopedics,the Affiliated Hospital of Chengdu University)
出处
《西南医科大学学报》
2018年第6期508-513,共6页
Journal of Southwest Medical University
基金
四川省卫生和计划生育委员会项目(17PJ193)
作者简介
第一作者:窦畅,主管护师;通信作者:聂海,主任医师,博士。E-mail:175928668@qq.com.
