微创肩锁、喙锁韧带重建与锁骨钩钢板置入固定治疗肩锁关节脱位的效果比较

Comparison of minimally invasive acromioclavicular and coracoclavicular ligament reconstruction and clavicular hook plate fixation treating acromioclavicular joint dislocation

目的探讨微创肩锁、喙锁韧带重建与锁骨钩钢板置入固定治疗肩锁关节脱位的效果。方法将2017年5月~2018年2月在我院骨科收治的60例肩锁关节脱位患者随机分为两组,对照组采用锁骨钩钢板置入固定治疗,观察组采用微创小切口下行锚钉修复并重建肩锁、喙锁韧带治疗。比较两组患者的手术效果、各项手术指标、并发症发生率。结果观察组术后1个月的Karksson评分优良率为96.67%,明显高于对照组的80.00%(P<0.05)。观察组的手术时间、住院时间明显短于对照组,术中出血量明显少于对照组,术后1 d的VAS疼痛评分明显低于对照组,末次随访Constant-Murley评分明显高于对照组(P<0.05)。观察组术后肩周炎、肩峰撞击、肩峰下骨侵蚀、肩锁关节再脱位的并发症总发生率明显低于对照组(P<0.05)。结论微创肩锁、喙锁韧带重建治疗肩锁关节脱位的效果更佳,可明显改善肩关节功能,韧带愈合可靠,并发症发生率低,具有积极的临床意义。

Objective To compare the effect of minimally invasive acromioclavicular and coracoclavicular ligament reconstruction and clavicular hook plate fixation treating acromioclavicular joint dislocation. Methods Sixty patients with acromioclavicular joint dislocation admitted to our department from May 2017 to February 2018 were randomly divided into the two groups. In the control group, clavicular hook plate fixation was used, while in the observation group, mitek repair with acromioclavicular and coracoclavicular ligament reconstruction in minimally invasive small incision was adopted. The surgical effect, various surgical indexes and incidence of complication of patients between the two groups were compared. Results The excellent and good rate of Karksson score in the observation group was 96.67% one month after operation, which was significantly higher than that in the control group(80.00%)(P<0.05). The operation time and hospital stay of the observation group were greatly shorter than those of the control group, the amount of bleeding during operation was significantly less than that of the control group,the VAS pain score of the first day after operation was significantly lower than that of the control group, and the Constant-Murley score of the last follow-up was significantly higher than that of the control group(P<0.05). The total incidence of complications including postoperative periodontitis, acromial impingement, subacromial bone erosion, and re-dislocation of acromioclavicular joint was lower than that of the control group(P<0.05). Conclusion Minimally invasive acromioclavicular and coracoclavicular ligament reconstruction is more better treating acromioclavicular joint dislocation, which obviously improves the shoulder joint function at advantages of reliable ligament healing and low complication rate, and has positive clinical significance.