穿梭导线小隧道Endobutton技术治疗Rockwood Ⅲ型急性肩锁关节脱位的疗效分析

String-shuttling assisted Endobutton technique for acute acromioclavicular dislocation of Rockwood type Ⅲ

目的探讨穿梭导线小隧道Endobutton技术治疗RockwoodⅢ型急性肩锁关节脱位的疗效。方法回顾性分析2018年3月至2019年3月期间江门市中心医院运动医学与足踝外科收治的15例RockwoodⅢ型急性肩锁关节脱位患者资料。男10例,女5例;年龄为22~36岁,平均30.6岁。受伤至手术时间平均为12.4 d(4~15 d)。所有患者均采用穿梭导线小隧道Endobutton技术治疗。记录患者的手术时间、术中出血量、末次随访时疼痛视觉模拟评分(VAS)和肩关节功能、随访期间并发症发生情况等。结果15例患者术后获8~12个月(平均9.8个月)随访。本组患者的手术时间为85~115 min,平均101.1 min;术中出血量为50~100 mL,平均75.3 mL。末次随访时疼痛VAS评分由术前7.0(4.5,8.0)分降低至0.0(0.0,1.0)分,Constant评分由术前(56.3±6.2)分提高至(93.0±4.8)分,差异均有统计学意义(P<0.05)。随访期间无一例患者发生切口感染、切口周围浅感觉减退、复位丢失、内固定物断裂或滑脱、喙突或锁骨骨隧道骨折等并发症。结论穿梭导线小隧道Endobutton技术治疗RockwoodⅢ型急性肩锁关节脱位,可有效避免骨隧道骨折并发症,术后患者肩关节功能恢复良好。

Objective To evaluate the efficacy of string-shuttling assisted Endobutton technique for acute acromioclavicular dislocation of Rockwood TypeⅢ.Methods From March 2018 to March 2019,15 patients were treated at Department of Sports Medicine and Ankle&Foot,Central Hospital of Jiangmen for acute acromioclavicular dislocation of Rockwood TypeⅢ.They were 10 men and 5 women,aged from 22 to 36 years(average,30.6 years).The intervals from injury to surgery averaged 12.4 d(from 4 to 15 d).They were all treated by string-shuttling assisted Endobutton technique.Recorded were operation time,intraoperative blood loss,visual analogue scale(VAS)pain score and shoulder function at the final follow-up,and complications during follow-up.Results This group was followed up for 8 to 12 months(9.8 months on average).Their operation time ranged from 85 to 115 min(101.1 min on average)and intraoperative blood loss from 50 to 100 mL(75.3 mL on average).Their VAS pain score decreased significantly from preoperative 7.0(4.5,8.0)to 0.0(0.0,1.0)at the final follow-up,and their Constant score increased significantly from preoperative 56.3±6.2 to 93.0±4.8 at the final follow-up(both P<0.05).No patient reported incision infection,peri-incision hypoesthesia,loss of reduction,breakage or loosening of implants,or fracture of the clavicle tunnel or the coracoid process.Conclusion In the treatment of acute acromioclavicular dislocation of Rockwood TypeⅢ,string-shuttling assisted Endobutton technique can effectively avoid such a complication as tunnel fracture,leading to fine functional recovery of the shoulder.