自体或同种异体肌腱重建喙锁韧带联合锁骨钩钢板治疗肩锁关节脱位疗效分析

Reconstruction of acromioclavicular joint dislocation with autologous or allogenic tendon reconstruction of the beak locking ligament combined with clavicular hook plate

目的:探讨采用自体或同种异体肌腱重建喙锁韧带联合锁骨钩钢板治疗肩锁关节脱位的临床效果。方法:对医院手术治疗的248例肩锁关节脱位患者进行回顾性分析,根据治疗方法的不同将其分为治疗组(128例)和对照组(120例),治疗组采用自体或同种异体肌腱重建喙锁韧带联合锁骨钩钢板治疗,对照组单纯使用钩钢板治疗,对比两组治疗效果。结果:治疗组的手术时间、出血量、住院时间均显著的高于对照组,两组比较差异有统计学意义(t=6.205,t=10.156,t=4.748;P<0.05);术后3个月和6个月,治疗组患者的美国肩肘外科协会(ASES)评分显著的高于对照组(F=12.087,F=13.284;P<0.05);术后1周、3个月,治疗组的VAS评分显著的低于对照组(F=7.086,F=8.106;P<0.05);术后3个月、6个月,治疗组的喙锁间距测定值显著的低于对照组(F=5.572,F=7.116;P<0.05);末次随访时,治疗组患者的肩关节功能优于对照组(Z=-2.167,P<0.05)。结论:自体或同种异体肌腱重建喙锁韧带联合锁骨钩钢板治疗肩锁关节脱位的临床效果优于单纯使用钩钢板治疗。

Objective:To investigate the clinical effect of reconstructed coracoclavicular ligament of autologous or allogeneic tendon combined with hook steel plate of clavicle for acromioclavicular dislocation.Methods:248patients with acromioclavicular dislocation were researched by using retrospective analysis and all of these patients were divided into treatment group(128cases)and control group(120cases)as different therapeutic method.The patients of treatment group received reconstructed clavicular ligament of autologous or allogeneic tendon combined with clavicular hook plate,and the patients of control group only received the treatment of hook plate.The therapeutic effects of the two groups were compared and analyzed.Results:The operation time,bleeding volume and length of stay of treatment group were significantly higher than that of control group(t=6.205,t=10.156,t=4.748,P<0.05),respectively.At the post-operative3th month and6th month,the ASES of treatment group were significantly higher than that of control group(F=12.087,F=13.284,P<0.05),respectively.At post-operative1week and3th month,the VAS score of treatment group was significantly lower than that of control group(F=7.086,F=8.106,P<0.05),respectively.At the post-operative3th month and6th month,the estimated value of coracoclavicular separation distance of treatment group was significantly lower than that of control group(F=5.572,F=7.116,P<0.05).At the last follow-up,the shoulder joint function of treatment group was significantly better than that of control group(Z=-2.167,P<0.05).Conclusion:It is better to use the reconstructed coracoclavicular ligament of autologous or allogeneic tendon combined with clavicular hook plate than the only hook plate in the treatment of acromioclavicular joint dislocation.