关节镜下喙锁间弹性固定治疗急性肩锁关节脱位的临床疗效

Clinical efficacy of arthroscopic coracoclavicular elastic fixation for treating acute acromioclavicular joint dislocation

目的探讨关节镜下喙锁间弹性固定治疗急性肩锁关节脱位的临床疗效。方法选取40例肩锁关节脱位患者,按照随机数字表法分为观察组和对照组各20例。对照组采取锁骨钩钢板肩锁间固定,观察组采用关节镜下TightRope袢钢板喙锁间弹性固定治疗。所有患者治疗前后进行VAS及Constant评分,比较两组术中出血量、手术时间及术后住院时间,治疗后6个月按照Karlsson标准测定肩关节功能恢复情况,评价治疗的优良率。结果观察组手术时间、术后住院时间均较对照组短(P <0. 05),术中出血量明显少于对照组(P <0. 05);两组术后Constant评分较术前明显提升,VAS评分较术前明显降低(P <0. 05),且术后两组VAS及Constant评分比较差异均有统计学意义(P <0. 05)。观察组术后6个月肩关节功能恢复优良率为85. 00%,对照组为80. 00%;观察组肩关节功能恢复情况优于对照组(P <0. 05)。结论关节镜下TightRope袢钢板喙锁间弹性固定与锁骨钩钢板肩锁间固定均对急性肩锁关节脱位有着较好的疗效。在微创理念方面TightRope袢钢板喙锁间弹性固定术优于锁骨钩钢板肩锁间固定,疗效更满意。

Objective To explore the clinical efficacy of arthroscopic coracoclavicular elastic fixation for treating acute acromioclavicular joint dislocation. Methods A total of 40 patients with acromioclavicular joint dislocation were selected and divided into observation group and control group by random number table, with 20 cases in each group. The control group was treated with acromioclavicular fixation using clavicular hook plate, and the observation group with arthroscopic coracoclavicular elastic fixation using TightRope loop plate. All patients were evaluated by VAS and Constant score before and after treatment. The intraoperative blood loss, operation duration and postoperative hospital stay were compared between the two groups. The recovery of shoulder joint function was assessed according to Karlsson standard at 6 months after treatment, and the therapeutic excellent and good rate was evaluated. Results Compared to the control group, the operation duration and postoperative hospital stay were shorter ( P <0.05), and the intraoperative blood loss was significantly less in the observation group ( P <0.05);After operation, the Constant scores were significantly higher and the VAS scores were significantly lower in both groups compared to the preoperative scores ( P <0.05), and significant differences in the VAS score and Constant score were found between the two groups ( P <0.05 ). At 6 months after operation, the excellent and good rates of recovery of shoulder joint function were 85.00% and 80.00% in the observation group and control group respectively;The recovery of shoulder joint function in the observation group was superior to that in the control group ( P <0.05 ). Conclusion Both of arthroscopic coracoclavicular elastic fixation using TightRope loop plate and acromioclavicular fixation using clavicular hook plate are effective for acromioclavicular joint dislocation. In terms of minimally invasive concept, coracoclavicular elastic fixation using TightRope loop plate is superior to acromioclavicular fixation using clavicular hook plate,and obtains a more satisfactory efficacy.