双纽扣板与三纽扣板治疗Rockwood Ⅲ-Ⅳ型肩锁关节脱位的对比

Double endobuttons versus triple endobuttons for Rockwood type Ⅲ-Ⅳ acromioclavicular dislocation

[目的]探讨比较双纽扣板技术与三纽扣板技术治疗Rockwood Ⅲ-Ⅳ型肩锁关节脱位的临床疗效。[方法]回顾性分析自2015年6月~2017年9月本院收治的64例Rockwood Ⅲ-Ⅳ型肩锁关节脱位患者,按固定方式分为双纽扣组32例,三纽扣组32例。记录比较两组围手术期、随访和影像指标。[结果]两组患者均顺利接受手术,两组间切口长度、术中出血量、手术时间,住院时间相似,差异无统计学意义(P>0.05),但双纽扣板组的费用明显低于三纽扣板组,差异有统计学意义(P<0.05)。所有患者术后平均随访23.46月。术后3个月,术后1年时两组Constant评分和VAS评分的差异无统计学意义(P>0.05)。两组间总体并发症发生率(53%vs 50%,P=0.674),差异无统计学意义。[结论]双纽扣组与三纽扣组均可有效治疗Rockwood Ⅲ-Ⅳ型肩锁关节脱位,但三纽扣组并没有表现出显著的临床优势,且住院费用高于双纽扣组。

[Objective] To investigate the clinical results of double-endobutton versus triple-endobutton technique for treatment of Rockwood type Ⅲ-Ⅳ acromioclavicular dislocation. [Methods] A retrospective study was conducted on 64 patients with Rockwood type Ⅲ-Ⅳ acromioclavicular dislocation treated surgically in our department form June 2015 to September 2017. In term of fixation technique, 32 patients had the joint fixed with double endobuttons, while the remaining 32 patients received fixation with triple endobuttons. The parameters in perioperative period, at follow-ups and on imagines were compared between the two groups. [Results] The patients in both groups underwent operation successfully, without significant differences in incision length, intraoperative bleeding, operation time and hospital stay between them（P〉0.05）, however, the double-endobutton group costed considerably less than the triple-endobutton group（P〈0.05）. All the patients were followed up for an average of 23.46 months. No statistical differences were found in Constant scores and VAS scores at 3 months and 1 year after operation（P〈0.05）. In addition, no statistically significant differences in the total incidence of complication were noted between the two groups（53% versus 50%, P=0.674）. [Conclusion] Both double endobuttons and tripe endobuttons do effectively treat Rockwood type Ⅲ-Ⅳ acromioclavicular dislocation, however the tripe endobuttons cost too much, with no remarkable advantages over the double endobuttons.