钩钢板钩端深度与肩峰高度的差值对术后发生肩峰下撞击综合征的影响

Effect of Difference between Depth of Hook End of Hook Plate and Height of Acromion on Occurrence of Subacromial Impingement Syndrome after Operation

目的探讨钩钢板钩端深度与肩峰高度的差值对术后发生肩峰下撞击综合征(subacromial impingement syndrome,SIS)的影响。方法回顾性分析2018年3月至2020年3月我院收治的113例使用锁骨钩钢板治疗肩锁关节脱位的病人,根据术后是否出现SIS分为两组,SIS阳性组25例,男17例,女8例,年龄为(30.24±6.98)岁(19~48岁),左侧11例,右侧14例;SIS阴性组88例,男49例,女39例,年龄为(33.24±9.27)岁(21~54)岁,左侧31例,右侧57例。基于冠状面CT测量病人的肩峰高度,记录病人所用钩钢板的钩端深度,并计算两者的差值。结果SIS阳性组与SIS阴性组的肩峰高度比较,差异无统计学意义(t=0.545,P=0.587)。SIS阳性组钩钢板的钩端深度与肩峰高度的差值为(8.063±1.150)mm(5.5~10.4 mm),SIS阴性组的差值为(6.715±1.820)mm(3.68~10.16 mm),差异有统计学意义(t=3.384,P=0.001)。钩钢板钩端深度与肩峰高度的差值>6 mm的病人中SIS的发生率(29.11%)与差值≤6 mm的病人中SIS的发生率(5.88%)比较,差异有统计学意义(t=7.446,P=0.006)。结论锁骨钩钢板的钩端深度与肩峰高度的差值大于6 mm可能是锁骨钩钢板术后发生SIS的影响因素。术前测量肩峰高度可以对术中选择钩钢板的型号提供建议。

Objective To explore the effect of the difference between the depth of the hook end of hook plate and the height of acromion on the occurrence of subacromial impingement syndrome(SIS)operation.Methods A total of 113 patients with acromioclavicular dislocation treated with clavicular hook plate in our hospital from March 2018 to March 2020 were retrospectively analyzed.They were divided into two groups according to whether SIS occurred after operation.There were 25 cases in SIS positive group,17 males and 8 females,aged(30.24±6.98)(19-48)years old,11 cases on the left and 14 cases on the right,and 88 cases in SIS negative group,49 males and 39 females,aged(33.24±9.27)(21-54)years old,31 cases on the left and 57 cases on the right.The height of the acromion was measured by CT on the coronal plane,then the depth of the hook end of the hook plate used by the patient and the height of the acromion were recorded,and the difference between them was calculated.Results The difference in the acromion height between the two groups was not statistically significant(t=0.545,P=0.587).The difference between the depth of the hook plate and the height of the acromion in the SIS positive group was(8.063±1.150)mm(5.5-10.4 mm),and(6.715±1.820)mm(3.68-10.16 mm)in the SIS negative group with the difference being statistically significant(t=3.384,P=0.001).The incidence of SIS in patients with the difference between the depth of the hook plate and the height of the acromion>6 mm(29.11%)was significantly higher than that in patients with the difference≤6 mm(5.88%)(t=7.446,P=0.006).Conclusion The occurrence of SIS after clavicular hook plate may be related to the difference between the depth of hook plate and the height of acromion.When the difference is greater than 6 mm,it may be a factor affecting the occurrence of SIS.Pre-imaging measurement of acromion height can provide suggestions for selecting the type of hook plate during operation.