锁扣带袢钛板联合锚钉治疗Tossy Ⅲ型肩锁关节脱位的疗效分析

Analysis of the curative efficacy of the locking band loop titanium plate combined with anchors in the treatment of Tossy Ⅲ acromioclavicular joint dislocation

目的比较锁扣带袢钛板(TightRope)重建喙锁韧带联合锚钉修复肩锁韧带与单纯锁骨钩钢板治疗TossyⅢ型肩锁关节脱位的疗效。方法将72例Tossy Ⅲ型肩锁关节脱位患者按内固定方法分为观察组(采用TightRope+3.5 mm锚钉,35例)和对照组(采用锁骨钩钢板,37例)。记录两组手术时间、术中出血量及术后并发症;按Constant-Murley肩关节功能评分评价疗效。结果患者均获得随访,时间12~18个月。对照组于术后6~11个月拆除内固定。两组手术时间、术中出血量差异无统计学意义(P>0.05)。术后3、6个月及末次随访Constant-Murley肩关节功能评分:观察组分别为(88.4±1.7)、(90.0±2.9)、(90.8±2.4)分,对照组分别为(82.1±2.1)、(86.4±1.8)、(86.6±1.7)分,差异均有统计学意义(P<0.05)。并发症发生率:观察组为5.71%,对照组为24.32%,两组比较差异有统计学意义(P<0.05)。结论与单纯锁骨钩钢板相比,TightRope重建喙锁韧带联合锚钉修复肩锁韧带治疗Tossy Ⅲ型肩锁关节脱位可以更好地促进肩关节功能恢复,减少肩峰撞击及肩峰下骨溶解等并发症的发生,并能避免二次内固定取出术。

Objective To compare the effect of the locking band loop titanium plate(TightRope)combined with anchors and the only clavicular hook plate in the treatment of the TossyⅢacromioclavicular joint dislocation.Methods The 72 cases of TossyⅢacromioclavicular joint dislocation were divided into two groups.There were 35 cases in the observation group(TightRope+3.5 mm anchor),and 37 cases in the control group(claviclular hook plate).The operation time and the intraoperative bleeding volume,the postoperative complications in the two groups were recorded.The clinical effect was evaluated by Constant-Murley shoulder function score criteria.Results All patients were followed up for 12~18 months.The clavicular hook plate in the control group was removed at 6~11 months after the operation.There were no statistically significant differences in operation time,intraoperative blood loss of two groups(P>0.05).The Constant-Murley scores of shoulder joint at 3,6 months and last follow-up after the operations:In the observation group,the results of the three assessment were 88.4±1.7,90.0±2.9 and 90.8±2.4,respectively;and in the control group,the results were 82.1±2.1,86.4±1.8,86.6±1.7,respectively;there were significant differences between the two groups in the three periods(P<0.05).The incidence rate of complications in the observation group was 5.71%,and that was 24.32%in the control group,there was statistically significant difference between the two groups(P<0.05).Conclusions Compared with the only clavicular hook plate,the locking with plate titanium plate combined with anchors have the advantages in repairing the acromioclavicular ligament in treatment of TossyⅢacromioclavicular joint dislocation,which can reduce impingement,acromial end osteolysis and avoid additional internal fixation operation.