| 自制导向器引导下双股钛缆与锁骨钩钢板治疗严重肩锁关节脱位 |
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投稿时间：2020-06-19
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| 作者 | Author | 单位 | Address | E-Mail |
| 王俊 |
WANG Jun |
温州医科大学附属萧山医院萧山区第一人民医院骨科, 浙江杭州 311201 |
Department of Orthopaedics, Xiaoshan First People's Hospital, Hangzhou Affiliated to Wenzhou Medical University, Hangzhou 311201, Zhejiang, China |
junee@126.com |
| 刘敏波 |
LIU Min-bo |
温州医科大学附属萧山医院萧山区第一人民医院骨科, 浙江杭州 311201 |
Department of Orthopaedics, Xiaoshan First People's Hospital, Hangzhou Affiliated to Wenzhou Medical University, Hangzhou 311201, Zhejiang, China |
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| 崔永锋 |
CUI Yong-feng |
温州医科大学附属萧山医院萧山区第一人民医院骨科, 浙江杭州 311201 |
Department of Orthopaedics, Xiaoshan First People's Hospital, Hangzhou Affiliated to Wenzhou Medical University, Hangzhou 311201, Zhejiang, China |
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| 期刊信息：《中国骨伤》2021年，第34卷，第3期，第237-242页 |
| DOI：10.12200/j.issn.1003-0034.2021.03.010 |
| 基金项目: |
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中文摘要:
目的：比较钛缆仿生重建喙锁韧带与锁骨钩钢板治疗肩锁关节脱位的临床疗效。
方法：回顾分析2017年1月至2018年12月39例严重急性肩锁关节脱位患者的临床资料，其中双股钛缆组19例，其中男13例，女6例；年龄26~67；RockwoodⅢ型10例，Ⅳ型4，V型5例；交通伤8例，摔伤11例；受伤至手术时间3~6 d。钢板组20例，其中男15例，女5例；年龄25~71岁；Rockwood Ⅲ型11例，Ⅳ型4例，Ⅴ型5例；交通伤7例，摔伤13例；受伤至手术时间2~7 d。比较两组手术切口长度、手术时间、术中出血量、花费以及手术前后VAS评分；手术前后采用Constant-Murley评分评估手术疗效。术后拍摄X线片观察肩锁关节脱位的复位及维持情况。同时记录并发症发生情况。
结果：36例患者获随访，时间12~14个月。两组术中出血量基本相同，手术切口两股钛缆组较短，手术时间钢板组较短，两股钛缆组手术费用少。术后1周与1年，两股钛缆组比钢板组疼痛轻。两股钛缆组术后1年比钢板组Constant-Murley评分高。术后X线片示两股钛缆组肩锁关节得到良好复位，有1例出现复位轻度丢失。钢板组在锁骨钩钢板取出后无复位丢失，8例患者出现锁骨远端骨萎缩或肩峰骨吸收。钢板组4例出现术后长期疼痛，术后功能障碍等诸多并发症。
结论：双股钛缆仿生重建喙锁韧带治疗严重急性肩锁关节脱位手术疗效优于锁骨钩钢板，创伤更小（无须二次手术），花费更低。 |
| 【关键词】肩锁关节 脱位 喙锁韧带 |
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| Treatment of severe acromioclavicular joint dislocation with double strand titanium cable and clavicular hook plate guided by self-made guide device |
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ABSTRACT
Objective: To compare the clinical efficacy of titanium cable biomimetic reconstruction of coracoclavicular ligament and clavicular hook plate in the treatment of acromioclavicular joint dislocation.
Methods: The clinical data of 39 patients with severe acute acromioclavicular joint dislocation from January 2017 to December 2018 were retrospectively analyzed,19 patients in double strand titanium cable group,including 13 males and 6 females,aged from 26 to 67 years old;Rockwood classification:10 cases of type Ⅲ,4 cases of type Ⅳ and 5 cases of type Ⅴ;8 cases of traffic injury and 11 cases of fall injury;the time from injury to operation was 3 to 6 days. There were 20 patients in steel plate group,including 15 males and 5 females,aged from 25 to 71 years old. Rockwood classification:11 cases of type Ⅲ,4 cases of typeⅣ,5 cases of type Ⅴ;7 cases of traffic injury,13 cases of fall injury;the time from injury to operation was 2 to 7 days. The length of incision,operation time,intraoperative blood loss,cost,VAS score before and after operation,and Constant-Murley score before and after operation were compared between two groups. Postoperative X-ray films were taken to observe the reduction and maintenance of acromioclavicular joint dislocation. Complications were recorded.
Results: Thirty-six patients were followed up for 12 to 14 months. The amount of intraoperative blood loss in the two groups was basically the same. The operation incision in double strand titanium cable group was shorter,the operation time in steel plate group was shorter,and the operation cost in double strand titanium cable group was less. One week and one year after operation,the pain of double strand titanium cable group was less than that of steel plate group. One year after operation,the Constant-Murley score of double strand titanium cable group was higher than that of steel plate group. The postoperative X-ray showed that the acromioclavicular joint in double strand titanium cable group was well reduced,and there was 1 case with slight reduction loss. In the plate group,there was no reduction loss after removal of the clavicular hook plate,and 8 patients had distal clavicular bone atrophy or acromion bone resorption. In steel plate group,4 cases had long-term postoperative pain,postoperative dysfunction and other complications.
Conclusion: The clinical effect of coracoclavicular ligament reconstruction with double strand titanium cable is better than that of clavicular hook plate in the treatment of severe acute acromioclavicular joint dislocation,with less trauma (no secondary operation) and lower cost. |
| KEY WORDS Acromioclavicular joint Dislocations Coracoclavicular ligament |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王俊,刘敏波,崔永锋.自制导向器引导下双股钛缆与锁骨钩钢板治疗严重肩锁关节脱位[J].中国骨伤,2021,34(3):237~242 |
| 英文格式: | WANG Jun,LIU Min-bo,CUI Yong-feng.Treatment of severe acromioclavicular joint dislocation with double strand titanium cable and clavicular hook plate guided by self-made guide device[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(3):237~242 |
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