关节镜辅助Endobutton带袢钢板对Rockwood Ⅲ~Ⅴ型急性肩锁关节脱位患者肩关节功能的影响

Effect of Arthroscopically Assisted Endobutton Plate with Tabs on Shoulder Function in Patients with Rockwood Ⅲ-Ⅴ Acute Acromioclavicular Dislocation

目的探究关节镜辅助Endobutton带袢钢板对Rockwood Ⅲ~Ⅴ型急性肩锁关节脱位患者肩关节功能的影响。方法收集2019年2月至2022年1月开封市第二中医院收治的94例Rockwood Ⅲ~Ⅴ型急性ACJ脱位患者,按手术方案分成A组(47例)、B组(47例)。B组治疗术式为锁骨钩钢板(CHP)固定,A组治疗术式为关节镜辅助Endobutton带袢钢板重建喙锁韧带。对比两组围手术期指标、手术效果、手术前后Constant-Murley评分、创伤应激指标[白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-10(IL-10)]水平、并发症发生率。结果A组优良率(97.87%)较B组(73.33%)高(P<0.05);A组手术时长较B组长,术中失血量较B组少,住院时长较B组短(P<0.05);术后3个月A组疼痛、功能活动、肌力情况、关节活动范围评分较B组高(P<0.05);术后1 d A组血清IL-10、TNF-α、IL-1、CRP水平较B组低(P<0.05);A组并发症总发生率(2.13%)较B组(19.15%)低(P<0.05)。结论相较于CHP固定治疗Rockwood Ⅲ~Ⅴ型急性ACJ脱位患者,应用关节镜辅助Endobutton带袢钢板治疗于提升手术效果、改善肩关节功能、减少术中失血量、缩短住院时长方面更具优势,且对机体创伤应激影响更小,但手术时长较长。

Objective To investigate the effect of arthroscopically assisted Endobutton plate with tabs on shoulder joint function in patients with Rockwood Ⅲ-Ⅴ acute acromioclavicular dislocation.Methods Ninety-four patients with Rockwood Ⅲ-Ⅴ acute ACJ dislocation were collected in Kaifeng Second Hospital of Traditional Chinese Medicine from February 2019 to January 2022,and divided into group A(47 cases)and group B(47 cases)according to surgical protocols.Group B received clavicle hook plate(CHP)fixation,and group A received arthroscopic-assisted Endobutton plate with tabs to reconstruct the rostral lock ligament.The perioperative indexes,surgical outcomes,Constant-Murley scores,traumatic stress indexes[interleukin-1(IL-1),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-10(IL-10)]levels and complication rates were compared between the two groups.Results The excellent rate in group A(97.87%)was higher than that in group B(73.33%)(P<0.05).The duration of surgery in group A was longer than that in group B,the intraoperative blood loss was less than that in group B,and the length of hospitalization was shorter than that in group B(P<0.05).The pain,functional activity,muscle strength condition and joint range of motion scores in group A were higher than those in group B at 3 months after surgery(P<0.05).One day after surgery,the serum IL-10,TNF-α,IL-1 and CRP levels in group A were lower than in group B(P<0.05).The overall complication rate in group A(2.13%)was lower than in group B(19.15%)(P<0.05).Conclusion Compared with CHP fixation for patients with Rockwood Ⅲ-Ⅴ acute ACJ dislocation,the application of arthroscopic-assisted Endobutton plate with collaterals is more advantageous in enhancing surgical results,improving shoulder function,optimally reducing intraoperative blood loss and shortening the length of hospital stay.It has less impact on the traumatic stress of the body.But the duration of surgery is slightly longer.