自体双股掌长肌腱联合人工韧带重建喙锁韧带治疗肩锁关节脱位

Coracoclavicular ligament reconstruction using autologous double-strand palmaris longus tendon and artificial ligament for the treatment of acromioclavicular joint dislocation

目的:探讨应用自体双股掌长肌腱联合人工韧带重建喙锁韧带治疗肩锁关节脱位的手术方法及临床疗效。方法:2006年4月至2009年6月采用自体双股掌长肌腱联合人工韧带重建喙锁韧带治疗肩锁关节脱位31例,男18例,女13例;年龄18～60岁,平均35岁;急性损伤26例,慢性损伤5例。术前患者主要表现为不同程度肩部疼痛、活动受限、肩锁不稳,X线提示肩锁关节脱位。结果:术后切口愈合好,无一例血管及臂丛神经损伤。全部病例获得随访,平均时间23个月,JOA评分术前(38.8±1.5)分,术后1个月(73.2±1.1)分,末次随访(93.5±0.8)分。本组优28例,良2例,一般1例。结论:应用自体双股掌长肌腱联合人工韧带重建喙锁韧带同时行锁骨远端部分切除是治疗肩锁关节脱位的有效方法。

Objective：To investigate clinical effects of coracohumeral ligament reconstruction with autologous double-strand of long palmaris longus tendon and artificial ligament for the treatment of acromioclavicular joint dislocation.Methods：From April 2006 to June 2009,31 patients with acromioclavicular joint dislocation were treated with coracohumeral ligament reconstruction using autologous double-strand palmaris longus tendon and artificial ligament.There were 18 males and 13 females,ranging in age from 18 to 60 years,with an average of 35 years.Twenty-six patients were acute trauma and other 5 patients were chronic trauma.Preoperative symptoms included different degrees of pain,restricted movement,and instability of acromioclavicular joint.The X-ray showed acromioclavicular joint dislocation.Results：The patients had good incision union without vascular and nerve injuries.All the patients were followed up,and the average duration was 23 months.The JOA scores decreased from preoperative （38.8±1.5） to （73.2±1.1） at 1 month after operation,and （93.5±0.8）at the last follow-up.Twenty-eight patients got an excellent result,2 good and 1 fair.Conclusion：The reconstruction of coracohumeral ligament using auto-logous double-strand palmaris longus tendon and artificial ligament is an effective method for the treatment of acromioclavicular joint dislocation.