TightRope治疗Rockwood Ⅲ型肩锁关节脱位

Clinical analysis of TightRope in the treatment of Rockwood type IH acromioclavicular joint dislocation

目的分析TightRope治疗肩锁关节脱位技术要点,总结相关经验。方法自2014年1月至2018年4月收治肩锁关节脱位Rockwood HI型患者77例,均采用TightRope重建喙锁韧带治疗,术后发生钢板脱出、松动共6例。分析手术失败的原因。结果所有患者均获得随访,时间3~32个月,平均14.3个月,术后3个月Constant评分93.86±5.59。其中失效病例6例,术后3个月Constant W 79.17±7.330失败的原因包括隧道建立偏斜3例,手术操作不当2例,肩锁关节过度复位1例。结论TightRope治疗肩锁关节脱位具有创伤小、疼痛少、无需二次手术的优点。但也存在不足,仍需进一步长期随访。

Objective To analyze the technical points of TightRope in the treatment of acromioclavicular joint dislocation and summarize relevant experience. Methods From January 2014 to April 2018,77 patients with Rockwood type HI acromioclavicular dislocation were treated with TightRope to reconstruct coracoclavicular ligament. There were 6 cases of plate prolapse and loosening after the operation. The reasons for the failure of the operation were analyzed. Results All the patients were follow-up for 3 to 32 months, with an average of 14.3 months. The Constant score was 93.86±5.59 three months after the operation. The Constant score was 79.17±7.33 three months after the operation in 6 cases of failure. The causes of failure included deviation of tunnel construction in 3 cases, improper operation in 2 cases and excessive reduction of acromioclavicular joint in 1 case. Conclusion The application of TightRope in the treatment of acromioclavicular joint dislocation has the advantages of less trauma, less pain and no need for secondary operation. However, there are still some shortcomings, which need further long-term follow-up.