摘要
目的探讨肩关节镜下Dog-Bone双钛板治疗急性肩锁关节脱位的临床疗效。方法回顾性分析江苏省苏北人民医院运动医学科自2018年11月至2020年12月使用肩关节镜下Dog-Bone装置完成复位固定术的20例急性肩锁关节脱位患者资料。男11例,女9例;年龄31~63岁。收集术前和末次随访时患者的疼痛视觉模拟评分(VAS)、Constant-Murley肩关节功能评分(Constant评分)、肩关节前屈活动度,同时收集术后1个月和末次随访时的X线片参数[包括喙锁距离(CCD)、上下Dog-Bone钛板之间的距离(DDD)、锁骨喙突隧道与锁骨上缘切线之间的角度(CTCA)、锁骨隧道与喙突隧道的宽度)]及并发症发生情况。结果20例患者术后获6~12个月(平均10.5个月)随访。术前患者的VAS评分、Constant评分、肩关节前屈活动度分别为3.0(3.0,4.0)分、57.0(54.3,61.5)分、130°(110°,140°),末次随访时分别为0(0,0.8)分、90.0(86.5,91.0)分、170°(170°,180°),末次随访时以上指标均较术前明显改善,差异均有统计学意义(P<0.05)。术后1个月患者的CCD、DDD、CTCA、锁骨及喙突隧道宽度分别为(5.0±1.0)mm、(32.4±3.5)mm、91.7°(88.5°,104.9°)、3.0(3.0,3.0)mm、3.0(3.0,3.0)mm,末次随访时以上指标分别为(6.3±1.3)mm、(32.8±3.7)mm、84.8°(81.8°,92.0°)、3.5(3.4,3.6)mm、3.2(3.1,3.3)mm,以上指标除DDD外术后1个月与末次随访时比较差异均有统计学意义(P<0.05)。末次随访时仅有1例患者出现术后复位再丢失。结论对于急性肩锁关节脱位,肩关节镜下Dog-Bone固定技术有创伤小、术后肩关节功能恢复良好且能有效防止复位再丢失等优势,具有较好的手术疗效和患者满意度。
Objective To investigate the clinical efficacy of Dog-Bone double button in the treatment of acute acromioclavicular dislocation under shoulder arthroscopy.Methods A retrospective analysis was conducted of the 20 patients with acute acromioclavicular dislocation who had been treated at Department of Sports Medicine,Northern Jiangsu People's Hospital of Jiangsu Province from November 2018 to December 2020 by Dog-Bone double button under shoulder arthroscopy.They were 11 males and 9 females,aged from 31 to 63 years.Recorded were their visual analogue scale(VAS),Constant-Murley shoulder function score and range of shoulder anteflexion at preoperation and the last follow-up,as well as complications and the X-ray parameters at one month postoperation and the last follow-up[including coracoclavicular distance(CCD),distance between the upper and lower Dog-Bone titanium plates(DDD),angle between the coracoid process tunnel and the tangent line of the superior clavicle(CTCA),and widths of the clavicle tunnel and the coracoid process tunnel].Results The 20 patients were followed up for 6 to 12 months(average,10.5 months).Their preoperative VAS score,Constant score,and range of shoulder anteflexion were 3.0(3.0,4.0),57.0(54.3,61.5)and 130°(110°,140°),which were significantly improved to 0(0,0.8),90.0(86.5,91.0)and 170°(170°,180°)at the last follow-up(P<0.05).Their CCD,DDD,CTCA,and widths of the clavicle tunnel and the coracoid process at one month postoperation were(5.0±1.0)mm,(32.4±3.5)mm,91.7°(88.5°,104.9°),3.0(3.0,3.0)mm and 3.0(3.0,3.0)mm,which were significantly improved to(6.3±1.3)mm,(32.8±3.7)mm,84.8°(81.8°,92.0°),3.5(3.4,3.6)mm and 3.2(3.1,3.3)mm with the exception of DDD at one month postoperation(P<0.05).The last follow-up observed postoperative reduction loss in only one patient.Conclusion For acute acromioclavicular joint dislocation,the Dog-Bone fixation technique under shoulder arthroscopy can lead to fine surgical efficacy and patient satisfaction,because it has advantages of limited trauma,good functional recovery of the shoulder,and effective prevention of reduction loss.
作者
侯雷
庞尔凯
刘明生
谢彬
王炫棋
王静成
卢耀甲
费文勇
Hou Lei;Pang Erkai;Liu Mingsheng;Xie Bin;Wang Xuanqi;Wang Jingcheng;Lu Yaojia;Fei Wenyong(Dalian Medical University,Dalian 116044,China;Department of Sports Medicine,Northern Jiangsu People's Hospital of Jiangsu Province,Yangzhou 225001,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2021年第11期937-944,共8页
Chinese Journal of Orthopaedic Trauma
基金
江苏省青年医学人才计划(QNRC2016458)
江苏省医学创新团队项目(CXTDB2017004)。
关键词
肩锁关节
脱位
关节镜检查
Dog-Bone双钛板
喙锁距离
Acromioclavicular joint
Dislocation
Arthroscopy
Dog-Bone double button
Coracoclavicular distance
作者简介
通信作者:费文勇,Email:ydyx302@163.com。
