单一小切口结合蜂巢钛板治疗急性肩锁关节脱位
摘要点击次数: 157   全文下载次数: 101   投稿时间:2023-06-09    
作者Author单位AddressE-Mail
王雨辰 WANG Yu-chen 常州市武进中医医院骨伤科, 江苏 常州 213161 Department of Traumatology Orthopaedics, Wujin Hospital of Traditional Chinese Medicine, Changzhou 213161, Jiangsu, China  
俞伟忠 YU Wei-zhong 常州市武进中医医院骨伤科, 江苏 常州 213161 Department of Traumatology Orthopaedics, Wujin Hospital of Traditional Chinese Medicine, Changzhou 213161, Jiangsu, China ywzsci123@163.com 
李云峰 LI Yun-feng 常州市武进中医医院骨伤科, 江苏 常州 213161 Department of Traumatology Orthopaedics, Wujin Hospital of Traditional Chinese Medicine, Changzhou 213161, Jiangsu, China  
朱文科 ZHU Wen-ke 常州市武进中医医院骨伤科, 江苏 常州 213161 Department of Traumatology Orthopaedics, Wujin Hospital of Traditional Chinese Medicine, Changzhou 213161, Jiangsu, China  
贾川 JIA Chuan 常州市武进中医医院骨伤科, 江苏 常州 213161 Department of Traumatology Orthopaedics, Wujin Hospital of Traditional Chinese Medicine, Changzhou 213161, Jiangsu, China  
吴俊琪 WU Jun-qi 常州市武进中医医院骨伤科, 江苏 常州 213161 Department of Traumatology Orthopaedics, Wujin Hospital of Traditional Chinese Medicine, Changzhou 213161, Jiangsu, China  
高华 GAO Hua 常州市武进中医医院骨伤科, 江苏 常州 213161 Department of Traumatology Orthopaedics, Wujin Hospital of Traditional Chinese Medicine, Changzhou 213161, Jiangsu, China  
籍麟 JI Lin 常州市武进中医医院骨伤科, 江苏 常州 213161 Department of Traumatology Orthopaedics, Wujin Hospital of Traditional Chinese Medicine, Changzhou 213161, Jiangsu, China  
期刊信息:《中国骨伤》2024年,第37卷,第6期,第576-582页
DOI:10.12200/j.issn.1003-0034.20230268
基金项目:国家骨科与运动康复临床医学研究中心创新基金(编号:2021-NCRC-CXJJ-PY-28);常州市青苗人才项目(编号:CZQM2020121)
中文摘要:

目的: 探讨单一小切口结合蜂巢钛板治疗急性肩锁关节脱位的临床疗效。

方法: 回顾性分析2019年12月至2021年12月收治的40例急性肩锁关节脱位患者的临床资料,按照手术方法不同分为两组,其中20例采用单一小切口结合蜂巢钛板进行固定(钛板组),男11例,女9例,年龄23~65(47.40±12.58)岁;左侧12例,右侧8例;Rockwood分型,Ⅲ型11例,Ⅳ型3例,Ⅴ型6例。20例采用锁骨钩板固定(锁骨钩组),男8例,女12例,年龄24~65(48.40±12.08)岁;左侧9例,右侧11例;Rockwood分型,Ⅲ型10例,Ⅳ型2例,Ⅴ型8例。比较两组患者手术时间、切口长度、术中失血量、住院时间,以及术前和术后1、3、6个月时疼痛视觉模拟评分(visual analogue scale,VAS),肩关节功能Constant-Murley评分。分别于术前、术后即刻和术后6个月时拍摄患侧肩关节正位X线片,测量并比较喙锁间距。

结果: 两组患者均顺利完成手术,无严重并发症。40例均获随访,时间6~15(11.9±4.8)个月。未发生切口感染、内置物断裂或失效、骨隧道骨折等并发症。钛板组切口长度(35.90±3.14) mm,短于锁骨钩组(49.30±3.79) mm (P<0.05)。两组患者手术时间、术中失血量以及住院时间比较,差异均无统计学意义(P>0.05)。术后1、3个月时,钛板组VAS较锁骨钩组更低(P<0.05)。钛板组术后1、3、6个月Connstant-Murley评分分别为(86.80±1.36)、(91.60±2.32)、(94.90±2.22)分,较锁骨钩组(78.45±5.47)、(85.55±2.01)、(90.25±1.92)分更高(P<0.05)。两组术后即刻与术后6个月喙锁间距比较,差异均无统计学意义(P>0.05)。

结论: 单一小切口结合蜂巢钛板治疗急性肩锁关节脱位,切口更短,术后患者肩关节功能恢复更快,且无须二次手术,患者满意度较高。
【关键词】肩锁关节脱位  喙锁韧带  韧带重建  小切口
 
Single mini-incision combined with honeycomb titanium plate in treatment of acute acromioclavicular joint dislocation
ABSTRACT  

Objective To explore clinical effect of single small incision with honeycomb titanium plate in treating acute acromioclavicular dislocation.

Methods The clinical data of 40 patients with acute acromioclavicular dislocation admitted from December 2019 to December 2021 were retrospectively analyzed and divided into two groups according to different surgical methods. Among them,20 patients were fixed with single small incision with honeycomb titanium plate (titanium plate group),including 11 males and 9 females,aged from 23 to 65 years old with an average of (47.40±12.58) years old;12 patients on the left side,8 patients on the right side;11 patients with type Ⅲ,3 patients with type Ⅳ,and 6 patients with type Ⅴ according to Rockwood classification. Twenty patients were fixed with clavicular hook plate (clavicular hook group),including 8 males and 12 females,aged from 24 to 65 years old with an average of (48.40±12.08) years old;12 patients on the left side,8 patients on the right side;10 patients with type Ⅲ,2 patients with type Ⅳ,and 8 patients with type Ⅴ according to Rockwood classification. Operative time,incision length,intraoperative blood loss,hospital stay,visual analogue scale (VAS) and Constant-Murley score of shoulder joint function were compared between two groups. Anteroposterior radiographs of the affected shoulder joint were recorded before,immediately and 6 months after surgery,and the coracoclavicular distance was measured and compared.

Results Both groups of patients were successfully completed operation without serious complications. All patients were followed up for 6 to 15 months with an average of (11.9±4.8) months. There were no incisional infection,internal plant fracture or failure,bone tunnel fracture and other complications occurred. The incision length of titanium plate group (35.90±3.14) mm was significantly shorter than that of clavicular hook group (49.30±3.79) mm (P<0.05). There were no significant difference in operative time,intraoperative blood loss and hospital stay between two groups (P>0.05). At 1 and 3 months after operation,VAS of titanium plate group was lower than that of clavicular hook group (P<0.05). Connstant-Murley scores in titanium plate group at 1,3 and 6 months after operation were (86.80±1.36),(91.60±2.32) and (94.90±2.22),respectively;and in clavicular hook group were (78.45±5.47),(85.55±2.01) and (90.25±1.92),which were higher than that of clavicular hook group (P <0.05). There was no significant difference in coracoclavicular distance between two groups immediately and 6 months after operation(P>0.05).

Conclusion For the treatment ofacute acromioclavicular joint dislocation,single small incision combined with honeycomb titanium plate have advantages of shorter incision,fast recovery of shoulder joint function without the second operation,and has good satisfaction of patient.
KEY WORDS  cromioclavicular joint dislocation  Coracoclavicular ligament  Ligament reconstruction  Mini-incision
 
引用本文,请按以下格式著录参考文献:
中文格式:王雨辰,俞伟忠,李云峰,朱文科,贾川,吴俊琪,高华,籍麟.单一小切口结合蜂巢钛板治疗急性肩锁关节脱位[J].中国骨伤,2024,37(6):576~582
英文格式:WANG Yu-chen,YU Wei-zhong,LI Yun-feng,ZHU Wen-ke,JIA Chuan,WU Jun-qi,GAO Hua,JI Lin.Single mini-incision combined with honeycomb titanium plate in treatment of acute acromioclavicular joint dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(6):576~582
阅读全文  下载  查看/发表评论  下载PDF阅读器
关闭




版权所有:《中国骨伤》杂志社京ICP备12048066号-2  版权声明
地址:北京市东直门内南小街甲16号,100700
电话:010-64089487 传真:010-64089792 Email:zggszz@sina.com

京公网安备 11010102004237号