| 闵小军,潘昭勋,孙超,等.关节镜下重建喙锁韧带并修复肩锁韧带治疗Rockwood Ⅲ型肩锁关节脱位.骨科,2017,8(5): 360-364,378. |
| 关节镜下重建喙锁韧带并修复肩锁韧带治疗Rockwood Ⅲ型肩锁关节脱位 |
| Clinical effect of coracoclavicular ligament reconstruction and acromioclavicular ligament repair in the treatment of Rockwood Ⅲ acromioclavicular dislocation under arthroscopies |
| 投稿时间：2017-02-16 |
| DOI：10.3969/j.issn.1674-8573.2017.05.005 |
| 中文关键词: 关节镜 喙锁韧带 肩锁韧带 肩关节 |
| 英文关键词: Arthroscopies Coracoclavicular ligament Acromioclavicular ligament Shoulder |
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| 中文摘要: |
| 目的 探讨关节镜下重建喙锁韧带并修复肩锁韧带治疗Rockwood Ⅲ型肩锁关节脱位的临床疗效。方法 对我科2011年3月至2016年8月收治的60例Rockwood Ⅲ型肩锁关节脱位病人进行回顾性分析。其中男34例，女26例；左肩36例，右肩24例。年龄为23~48岁，平均年龄为（29.3±6.2）岁。受伤至手术时间为3~12 d，平均为（6.1±2.5） d。根据手术方法不同分为两组：修复组30例，使用关节镜下Endobutton技术重建喙锁韧带，采用5#爱惜帮聚酯纤维缝线修复肩锁韧带；对照组30例，使用关节镜下Endobutton技术重建喙锁韧带，不修复肩锁韧带。比较两组病人术后1年的肩锁关节前后位X线片的喙锁间隙数值以及术后1年的Constant-Murley肩关节功能评分。结果 随访时间为14~24个月，平均为（16±2.7）个月。所有病人手术切口均一期愈合，愈合时间为14~18 d，平均为（13±3.8） d，均无血管神经损伤。术后1年，修复组的喙锁间隙数值为（12.9±0.6） mm，优于对照组的（13.6±1.1） mm；修复组的Constant-Murley肩关节功能评分总分为（91.1±2.4）分，优于对照组的（86.3±3.5）分；上述指标组间差异均有统计学意义（P均＜0.05）。结论 关节镜下应用Endobutton技术重建喙锁韧带同时修复肩锁韧带治疗Rockwood Ⅲ型肩锁关节脱位，有利于肩锁关节稳定性及肩关节功能的恢复。 |
| 英文摘要: |
| Objective To analyze the clinical effect of coracoclavicular ligament reconstruction and acromioclavicular ligament repair in the treatment of Rockwood type Ⅲ acromioclavicular dislocation under arthroscopes. Methods From March 2011 to August 2016, 60 patients with Rockwood type Ⅲ acromioclavicular dislocation were treated by arthroscopic coracoclavicular ligament reconstruction. There were 34 males and 26 females aged from 23 to 48 years (average 29.3±6.2 years) with 36 cases on the left side and 24 on the right side. The time from injury to operation was 3-12 days (average 6.1±2.5 days). We reconstructed the coracoclavicular ligament with arthroscopic Endobutton technique in two groups. Thereafter the acromioclavicular ligament was sutured with 5# Ethibond polyester fiber in experimental group. Instead, we did nothing in control group. One year later, we compared the coracoclavicular distance in X-ray and the Constant-Murley score to evaluate the clinical efficacy. Results All patients were followed up for 14-24 months (average 16±2.7 months). All patients obtained postoperative incision healing. The healing time was 14-18 days (average 13±3.8 days). All patients had no vascular nerve injury. One year after operation the coracoclavicular distance was (12.9±0.6) mm in experimental group, and (13.6±1.1) mm in control group (P＜0.05). At the time of last follow-up, the Constant-Murley score was (91.1±2.4) in experimental group and (86.3±3.5) in control group (P＜0.05). Conclusion Arthroscopic Endobutton technique and acromioclavicular ligament repair to treat Rockwood type Ⅲ acromioclavicular dislocation can achieve a better stability and better function of shoulder. |
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