关节镜下带袢双钛板A-C tightrope内固定治疗肩锁关节脱位

Clinical Effect of A-C Tightrope Fixation with Assistance of Arthroscopy in Treatment of Acromioclavicular Joint Dislocation

目的观察在关节镜辅助下采用A-C tightrope内固定治疗肩锁关节脱位的临床疗效。方法回顾性分析自2012年5月至2013年9月,采用关节镜辅助下双钛板A-C tightrope固定治疗RockwoodⅢ、Ⅴ型肩锁关节脱位共25例,男13例,女12例;年龄25~56岁,平均(30.5±6.2)岁。术中我们可以先采用关节镜监视下直接或者间接法复位肩锁关节,后采用A-C tightrope线固定喙突和锁骨远端。末次随访采用Karlsson功能评分进行评价。结果所有患者伤口均一期愈合,未见复发性脱位、内固定松动。患者均获得随访,时间12~18个月,平均(15.3±3.8)个月。按Karlsson标准评定,优18例,良5例,差2例,优良率为92%。结论采用关节镜辅助下双钛板A-C tightrope内固定治疗肩锁关节脱位,具有微创、操作精准、肩关节功能恢复满意等优点。

Objective To Analyse the clinical effect of A-C tightrope fixation with assistance of arthroscopy in treatment of acromioclavicular joint dislocation.Methods From May 2012 to Sept 2013,there were 25 patients of acromioclavicular joint dislocation（Rockwood Ⅲ Ⅳ）treated with double titianium plate A-C tightrope fixation under arthroscopic vision,there were 13 males and 12 females,with an average age of（30.5±6.2）years（25 to 56 years）,during the surgey we could apply indirect or direct acromioclavicular joint dislocation reduction with arthroscopic inspection,and fix coracoid and distance clavicle with A-C tightrope ropes,Karlsson scores were applied to evaluate clinic effect in last follow-up.Results All the patient underwent the surgery successfully and there was no infection,no recurrent dislocation and inernal fixation loss.All the patients were followed up,the duration ranged from 12 to 18 months,with average of（15.3±3.8）months.The result of follow-up were excellent in 18 patients,good in 5 patients and poor in 2 patients with standard of Karlsson sores.The excellence and good rate was 92%.Conclusion There is some advantages of A-C tightrope fixation with assistance of arthroscopy in treatment of acromioclavicular joint dislocation,including less trauma,accurate manipulatation,satisficatory shoulder fuction recovery.