锁骨钩钢板治疗急性肩锁关节脱位喙锁韧带重建与否的疗效比较

Comparison between reconstructing and unreconstructing coracoclavicular ligament in treatment of acromioclavicular joint dislocation by hook plate

[目的]比较应用锁骨钩钢板治疗急性肩锁关节脱位时喙锁韧带重建与不重建的疗效,探讨喙锁韧带重建的必要性。[方法]回顾性研究2008年1月～2012年3月间采用锁骨钩钢板内固定治疗的59例TossyⅢ型新鲜肩锁关节脱位患者,其中喙锁韧带重建组28例,未行喙锁韧带重建组31例,定期随访对比观察两组疗效。[结果]所有患者均获随访并均于第一次术后2年内取出钢板,术后随访10～54个月,平均27个月,参照Karlsson标准:重建喙锁韧带组优18例、良9例、差1例,优良率96.4%,复发脱位0例;未重建组优21例、良8例、差2例,优良率93.5%,复发脱位1例。两组优良率和复发脱位率均无统计学差异(P>0.05)。[结论]锁骨钩钢板治疗急性肩锁关节脱位时重建喙锁韧带与不重建喙锁韧带疗效相近,不重建喙锁韧带在短期随访结果并未显示出较高的再脱位率。

[ Objective] To compare the efficacy between reconstructing and unreconstructing coracoclavicular ligament in treatment of acromioclavicular joint dislocation by hook plate, and explore the necessity for coracoclavicular ligament reconstruc- tion. [ Method ] Fifty-nine patients with Tossy III acromioclavicular joint dislocation from January 2008 to March 2012 were trea- ted with hook plate, of which 28 patients underwent reconstruction of the coracoclavicular ligament additionally,the other 31 pa- tients didnt accept reconstruction of the coracoclavicular ligament. [ Result] All patients were available for an average follow - up of 27 months（ range, 10 - 54 months） and implants were removed in the first 2 years after first surgery. The results were eval- uated by Karlsson standard. In reconstructing coracoclavicular ligament group, 18 patients were assessed as good,9 as fair and 1 as poor（ good and fair results 96.4% ） ,0 patient with recurrent dislocation. In unreconstructing coracoclavicular ligament group, 21 patients were assessed as good,8 as fair and 2 as poor（ good and fair results 93.5% ）, 1 patient with recurrent dislocation. There was no statistical difference between the two groups （P 〉 0.05 ）. [ Conclusion ] There were similar efficacy between recon- structing and unreconstructing coracoclavicular ligament in treatment of acromioclavicular joint dislocation by hook plate, and un- reconstructing coracoclavicular ligament group didnt show a higher re-dislocation rate in short-term follow-up.