微创双切口结合双带袢钢板固定技术治疗完全型肩锁关节脱位

Treatment of complete acromioclavicular joint dislocation by double Endobutton/Retrobutton technique via two mini-incisons

目的探讨利用微创双切口结合双带袢钢板固定技术治疗完全型肩锁关节脱位的临床效果。方法2007年12月至2010年5月，收治16例完全型肩锁关节脱位患者，设计在2个微创切口内，将肩锁关节复位后采用双带袢钢板固定及重建喙锁韧带。结果16例术后随访5～24个月，平均12．1个月，肩外形正常。X线片及CT复查肩锁关节鳃剖关系恢复。参照Karlsson标准评定：优14例，良2例；近期优良率100％。结论微创双切口在不增加手术时间的情况下，有效减少了手术创伤，双带袢钢板固定技术重建治疗完全型肩锁关节脱位，恢复了肩锁关节的解剖对位，能有效保证肩锁关节的垂直稳定及水平稳定，两者相结合具有疗效可靠、操作简便等优点，值得临床推广应用。

Objective To evaluate the etScacy of the double Endobutton/Retrobutton technique for the treatment of complete dislocation d the acromioclavicular joint. Methods From December 2007 to May 2010, 16 patients with complete acromioclavicular joint dislocation were treated by the double technique to reconstruct the conoid ligament via two mini-incisions. Results Postoperatively the patients were follow-up for 5 to 24 months, with an average of 12.1 months. The profile of the shoulders in all patients were normal and all postoperative mdlographs demonstrated excellent reduction of the coracoclavicular interval and the acromieclavicular joint in all the patients. According to the Karlsson criterion, the results were excellent in 14 patients and good in the other 2 patients. The short-term effective rate was 100%. Conclusion The double minl-incisions approach is less invasive without the need to increase surgery time. Double fixation enables an anatomical reduction of the acromioclavicular joint and restores stability of the acromioclavicular joint in the vertical and horizontal axis. This approach is simple, reproducible and reliable.