双Endobutton钢板与锁骨钩钢板内固定治疗Rockwood Ⅲ～Ⅴ型肩锁关节脱位的疗效比较

A comparative study of mid-term outcomes of double Endobutton technique and clavicular hook plate for acute acromioclavicular joint dislocation

目的比较双Endobutton钢板技术与锁骨钩钢板内固定治疗RockwoodⅢ-V型肩锁关节脱位的中期疗效。方法回顾性分析自2009-06—2014—05分别采用双Endobutton钢板与锁骨钩钢板内固定治疗的40例RockwoodⅢ-V型肩锁关节脱位。比较2组术后3个月、1年的患肩疼痛视觉模拟评分（VAS）、Constant肩关节功能评分。结果40例术后均随访满1年。Endobutton钢板组手术时间长于锁骨钩钢板组，差异有统计学意义（P〈0．05）。术后3个月Endobutton钢板组的Constant评分及VAS评分均优于锁骨钩钢板组，差异有统计学意义（P〈0．05、）；但2组术后1年Constant评分及VAS评分比较差异无统计学意义（P〉0．05）。2组术后1年Constant评分及VAS评分均优于术后3个月，差异有统计学意义（P〈0．05）。术后1年Endobutton钢板组l例出现复位丢失，1例出现肩部疼痛；锁骨钩钢板组未出现复位丢失，但5例肩部疼痛。结论双Endobutton钢板内固定治疗RockwoodⅢ-Ⅴ型肩锁关节脱位的中期效果与锁骨钩钢板内固定并无明显差异．但Endobutton钢板内固定对肩关节功能影响小、术后肩痛发生率低、内固定不必取出。

Objective To compare the mid-term clinical outcomes of double Endobutton technique and clavicular hook plate in the treatment of patients with acute dislocation of the acromioelavicular joint. Methods From June 2009 to May 2014, forty patients with acute acromioclavicular joint dislocation（Rockwood types llI, IV, V） were subjected to surgical treatment. They received eoracoelavieular ligament reconstruction using double Endobutton technique （10 patients） or clavicular hook plate（30 patients）. The 2 groups were compared at 3 months and 1 year after operation in terms of Constant score for shoulder, visual analog scale （VAS） and complications of shoulder. Results The average surgical time for the Endobutton group was significandy longer than that for the hook plate group （P 〈0.05）. At 3 month follow up, the Constant score and VAS score in the Endobutton group were both significantly better than those in the hook plate group （P 〈0.05）. According to Constant score and VAS score at 1 year after operation, the Endobutton group and the hook plate group had no significant difference （P 〉 0.05）. Both group had higher Constant score and VAS score at 1 year after operation compared with 3 months after operation. One and five cases of shoulder pain occurred one year after operation in the 2 groups respectively. One case of dislocation relapse was found in the Endobutton group while there was no ease found in the hook plate group. Conclusion Both double Endobutton technique and hook plate group are effective in the treatment of acute complete dislocation of the acromioclavicular joint, leading to similarly outcomes. However, Endobutton technique may be more advantageous in facilitating early functional recovery and pain-relieving of the shoulder.