带袢钢板重建喙锁韧带治疗肩锁关节脱位的疗效观察

Clinical Observation on Endobutton System Reconstituting Coracoclavicular Ligament for Treatment of Acromioclavicular Joint Dislocation

目的探讨分析应用带袢钢板重建喙锁韧带治疗Rockwood III型以上肩锁关节脱位的临床疗效.方法回顾性分析2012年1月至2014年6月应用带袢钢板重建喙锁韧带治疗的22例Rockwood III--VI型肩锁关节脱位的临床资料,其中III型7例,IV型10例,V型3例,VI型2例,观察记录手术时间、术后肩关节活动度、X线、术后并发症等指标.采用Constant-Murley评分评价术后3月、6月患肩功能.结果 22例不同分型肩锁关节脱位患者均获得随访,时间6～18个月,平均12个月,手术时间45～70 min,平均55 min;无钢板断裂、脱出,再脱位,肩峰撞击、术后疼痛等并发症.术后3月、6月Constant-Murley肩关节功能评分分值分别为（90.06±3.7）分、（95.12±1.6）分.结论带袢钢板重建喙锁韧带治疗Rockwood III型以上肩锁关节脱位具有良好疗效,且操作简便迅速,术后并发症少,肩关节功能恢复满意,是一种较为理想的恢复肩锁关节脱位生物学稳定的弹性固定方式.

Objective To analyze the clinical effect of endobutton system reconstituting coracoclavicular ligament in treatment of upper type Rockwood III acromioclavicular joint dislocation. Methods We retrospectively analyzed the data of 22 patients with Rockwood III- VI acromioclavicular joint dislocation treated with endobutton system reconstituting coracoclavicular ligament from January 2012 to June 2014, including 7 cases of Rockwood type III, 10 cases of Rockwood IV, 3 cases of Rockwood V and 2 cases of Rockwood 2. The operation time,postoperative shoulder joint activity, X- ray and postoperative complications were observed. The shoulder function on3 months and 6 months after operation was evaluated by Constant- Murley scores. Results All the 22 patients with different classification of acromioclavicular joint dislocation were followed up, for 6 to 18 months, with an average of 12 months, the operation time was 45- 70 min, with an average of 55 min, and no complications such as plate fracture, emergence, dislocation, shoulder peak impact, and postoperative pain occurred. The Constant- Murley score of shoulder function 3 moths and 6 months after operation was（ 90.06 ±3.7） and（ 95.12 ±1.6）,respectively. Conclusion Endobutton system reconstituting coracoclavicular ligament for treatment of acromioclavicular joint dislocation has good curative effect, and has the advantages of simple operation, less complications, and satisfactory recovery of shoulder joint function, is an ideal elastic fixed way for biological stability recovery of the acromioclavicular joint dislocation.