同种异体肌腱重建喙锁和肩锁韧带治疗肩锁关节脱位

Allogeneic tendon graft for reconstruction of the coracoclavicular and acromioclavicular ligaments in acromioclavicular dislocation

目的介绍应用同种异体肌腱重建喙锁和肩锁韧带治疗肩锁关节脱位的临床疗效。方法2010年2月至2012年2月，对6例肩锁关节脱位患者，应用同种异体肌腱“V”形重建喙锁和肩锁韧带，并跟踪随访其疗效。随访包括调查患者总体满意度，观察患肩外形，测量肩关节活动度，摄片评价肩锁关节复位维持情况，使用Constant-Murley肩关节评分和美国加州大学洛杉矶分校（UCLA）评分系统评价患肩功能，视觉模拟评分法（VAS）了解患者疼痛情况。结果术后平均随访时间为18个月，患者总体满意度为83．3％，所有患者肩关节外形正常，平均前屈上举163．50、外展上举147．20，Constant-Murley评分平均95．3分、UCLA评分平均32．8分、VAS评分平均0．3分。结论应用同种异体肌腱修复重建喙锁和肩锁韧带治疗肩锁关节脱位，符合生物力学要求，术后随访疗效满意，是一种有效的治疗方法。

Objective To introduce and evaluate a new reconstructive method for the coracoclavictdar and acromioclavieular ligaments using allogeneic tendon graft in the management aemmioelavicular joint dislocation. Methods Between February 2010 and February 2012, 6 cases of acromioclavicular joint dislocations were treated with allogeneic tendon graft to reconstruct the V structure of coracoclavicular and acromioclavicular ligaments in our clinic. Patient satisfaction, appearance of the shoulder, shoulder range of motion, maintenance of the reduced acmmioelavictdar joint in X-rays, Constant-Murley shoulder scores, UCLA shoulder scores and VAS for pain were documented during follow-up evaluation. Results The patients were available for a mean follow-up of 18 months （range, 8 to 25 months）. Patient satisfaction was documented as 83.3 %. All patients had a normal appearance of the shoulder. Flexion and abduction of the shoulder were 163.5° and 147.2° respectively. The mean Constant-Murley and UCLA shoulder scores were 95.3 and 32.8 respectively. The mean VAS score of the patients was 0.3. Conclusion Reconstruction of the coracoclavicular and aeromioclavicular ligaments with allogeneic tendon graft can achieve good outcomes in treatment of acmmioclavicular joint dislocation. It fulfills biomeehanical requirements and maintains sustainable and stable reduction of the joint.