跖肌腱重建喙锁韧带联合钩钢板治疗肩锁关节脱位的效果观察

Effect observation of coracoclavicular ligament reconstruction by metatarsalis tendon combined with hook plate in the treatment of patients with acromioclavicular joint dislocation

目的观察跖肌腱重建喙锁韧带联合钩钢板治疗肩锁关节脱位的效果。方法将82例肩锁关节脱位患者随机分为2组,每组41例。对照组行单纯钩钢板复位治疗,研究组行跖肌腱重建喙锁韧带联合钩钢板复位治疗。比较2组患者手术相关指标、肩关节功能、疼痛程度及预后。结果研究组术中出血量显著多于对照组(P<0.05),手术时间、住院时间显著长于对照组(P<0.05)。2组患者术后Constant-Murley量表评分显著提高(P<0.05),视觉模拟评分法(VAS)评分显著降低(P<0.05),且研究组Constant-Murley评分、VAS评分显著优于对照组(P<0.05)。对照组并发症发生率为31.71%,显著高于研究组的9.76%(P<0.05)。结论与单纯钩钢板复位方案相比,跖肌腱重建喙锁韧带联合钩钢板延长了肩锁关节脱位的手术时间,且出血量大,但能显著恢复患者肩关节功能,缓解疼痛,降低并发症发生率。

Objective To observe the effect of coracoclavicular ligament reconstruction by metatarsalis tendon combined with hook plate in the treatment of patients with acromioclavicular joint dislocation.Methods A total of 82 patients with acromioclavicular joint dislocation were randomly divided into two groups,with 41 cases in each group.Control group was treated with simple hook plate for restoration,and study group was treated with reconstruction of coracoclavicular ligament by metatarsalis tendon and hook plate restoration.The operation related indexes,shoulder joint function,pain degree and prognosis were compared between the two groups.Results The amount of intra-operative blood loss in the study group was significantly more than that in the control group(P<0.05),and the operation time and hospitalization time was significantly longer than those in the control group(P<0.05).After operation,the score of Constant-Murley scale significantly improved in both groups(P<0.05),the score of Visual Analogue Scale(VAS)significantly decreased(P<0.05),and the scores of Constant-Murley scale and VAS in the study group were significantly better than those of the control group(P<0.05).The incidence of complications in the control group was 31.71%,which was significantly higher than 9.76%in the study group(P<0.05).Conclusion Compared with the application effect of simple hook plate restoration,reconstruction of coracoclavicular ligament by metatarsalis tendon combined with hook plate can prolong the time of operation for acromioclavicular joint dislocation with a high amount of blood loss,but it can significantly restore shoulder joint function,relieve pain and reduce the incidence of complications.