重建肩锁韧带及喙锁韧带治疗陈旧性肩锁关节脱位

Treatment of old acromioclavicular dislocation by reconstruction of acromioclavicular and coracoclavicular ligaments

目的 探讨治疗陈旧性肩锁关节脱位的新方法。 方法 采用喙肩韧带加强重建肩锁韧带、喙突部肱二头肌短头与喙肱肌联合腱肌筋膜加强重建喙锁韧带治疗陈旧性肩锁关节脱位 2 9例 ,获得随访 2 5例 ,按Allman等分型 :Ⅱ度 10例 ,Ⅲ度 15例。随访观察 3～ 36个月。 结果依照Lazzcano评定标准 ,优 16例、良 9例 ,无其他并发症 ,肩锁关节无再脱位。 结论 喙肩韧带加强重建肩锁韧带、喙突部肱二头肌短头与喙肱肌联合腱肌筋膜加强重建喙锁韧带治疗陈旧性肩锁关节脱位既有良好固定脱位的作用 ,又符合肩锁关节的微动生理 ,是一种较为理想的治疗方法。

Objective To explore new treatment methods for old acromioclavicular dislocation. Methods Twenty-nine cases of old acromioclavicular dislocation were treated with augmenting reconstruction of acromioclavicular ligament by coracoacromial ligament and augmenting reconstruction of coracoclavicular ligament by conjoining tendon with biceps brachii muscle and coracobrachialis muscle in coracoid. Twenty-five cases were followed up with follow-up period of 3-36 months. There were 10 cases in grade Ⅱ and 15 in grade Ⅲ according to classification of Allman. Results Of 25 cases with follow-up, 16 were excellent and 9 satisfactory according to the Lazzcano standard. There were no other complications or dislocations. Conclusions Reconstruction of acromioclavicular and coracoclavicular ligaments for treatment of old acromioclavicular dislocation is an efficient method with advantage of rigid fixation and accords with micro-motion physiological function of acromioclavicular joint.