双Endobutton带袢钢板重建喙锁韧带术治疗Rockwood Ⅲ-Ⅴ型肩锁关节损伤的临床观察

Clinical Observation of Coracoclavicular Ligament Reconstruction with Double Endobouton Plate in the Treatment of Rockwood Type Ⅲ-Ⅴ Acromioclavicular Joint Injury

目的评价双Endobutton带袢钢板重建喙锁韧带治疗RockwoodⅢ~Ⅴ型肩锁关节损伤的临床安全性和有效性。方法选取2018年7月至2019年7月入我院诊断RockwoodⅢ~Ⅴ型肩锁关节损伤患者共60例,其中35例采用锁骨钩钢板固定肩锁关节术治疗(对照组),25例采用双Endobutton带袢钢板重建喙锁韧带术治疗(观察组),比较两组患者的手术指标(平均手术时间、术中出血量和术后康复时间),围手术期并发症,术后12、24和72 h的疼痛VAS评分,出院后第1、3、6月随访肩关节功能Constant评分及出院后第6月Constant评分疗效。结果两组平均手术时间比较无差异(P>0.05),但观察组术中出血量减少,术后康复时间缩短,围术期并发症发生率降低,差异有统计学意义(P<0.05)。结论双Endobutton带袢钢板治疗RockwoodⅢ~Ⅴ型肩锁关节脱位,是一种安全、有效的手术方式,值得临床推广。

Objective To evaluate clinical safety and efficacy of coracoclavicular ligament reconstruction with double endobutton plate in the treatment of Rockwood typeⅢ-Ⅴacromioclavicular joint injury.Methods From July 2018 to July 2019,60 patients with RockwoodⅢ-Ⅴacromioclavicular joint injury were selected and diagnosed in our hospital.Among them,35 patients were treated with clavicular hook plate fixation(control group),25 patients were treated with double endobutton plate reconstruction of the coracoclavicular ligament(observation group).The operation indexes(average operation time,intraoperative hemorrhage and postoperative rehabilitation)of the two groups were compared Time,perioperative complications,VAS score of pain at 12,24 and 72 h,Constant score of shoulder function at the first,third and sixth month after discharge,and the effect of Constant score at the sixth month after discharge.Results There was no significant difference between the two groups in the average operation time(P>0.05),but in the observation group,the amount of bleeding was reduced,the recovery time was shortened,and the incidence of perioperative complications was reduced(P<0.05).Conclusion The treatment of Rockwood typeⅢ-Ⅴacromioclavicular dislocation with double endobouton plate with a loop is a safe,reliable and effective surgical method,which is worthy of clinical promotion.