关节镜下Triple TRUE-button治疗肩锁关节脱位的疗效观察

Therapeutic effect of Triple TRUE-button assisted by arthroscopy on acromioclavicular joint dislocation

目的探讨关节镜下采用Triple TRUE-button治疗肩锁关节脱位的临床疗效。方法分析2018年12月至2019年12月南京中医药大学武进附属医院采用关节镜下使用Triple TRUE-button技术行喙锁韧带重建治疗肩锁关节脱位的患者15例。其中男9例,女6例;年龄21~58岁,平均38.2岁;左肩5例,右肩10例;Rockwood分型:Ⅲ型8例,Ⅴ型7例。记录患者术前和术后6个月的美国加州大学(UCLA)肩关节评分系统和Constant-Murley(CMS)评分;记录患者术前,术后2 d、6个月的患侧肩关节正位X片,测量喙锁间距(CCD);记录手术时间和并发症情况。结果15例患者均获得随访,随访时间6~19个月,平均13.3个月。所有患者切口均甲级愈合,无锁骨和喙突骨折等并发症。1例因术后外伤肩锁关节再脱位,行切开复位翻修。手术时间平均为(62.34±13.76)min。UCLA评分和CMS评分从分别从术前的(14.47±2.59)分和(74.40±3.92)分改善至术后的(26.87±1.37)分和(93.07±2.22)分,差异有统计学意义(P<0.05)。术前喙锁间距为(21.34±1.32)mm,术后6个月为(8.93±1.03)mm,差异有统计学意义(P<0.05)。结论关节镜下Triple TRUE-button技术治疗肩锁关节脱位可以取得满意的近期临床疗效,但其远期疗效仍需观察。

Objective To explore the clinical efficacy of Triple TRUE-button assisted by arthroscopy for treatment of acromioclavicular joint dislocation.Methods From December 2018 to December 2019,15 patients in Wujin Hospital Affiliated to Nanjing University of Chinese Medicine who underwent arthroscopic coracoclavicular ligament reconstruction using Triple TRUE-button technology were analyzed.There were 9 males and 6 females;aged from 21 to 58 years old,with an average age of 38.2 years;5 cases were left shoulder and 10 cases were right shoulder.According to Rockwood classification,8 cases were typeⅢand 7 cases were typeⅤ.The University of California at Los Angeles(UCLA)shoulder score system and Constant-Murley scores(CMS)were recorded before the operation and 6 months after the operation.The X-rays of the affected shoulder joint were recorded before the operation,2 d and 6 months after the operation,and the coracoclavicular distance(CCD)was measured,and operation time and complications were recorded.Results Fifteen cases were followed up for 6-19 months,with an average of 13.3 months.All incision healed without infection and no complications such as clavicle and coracoid fractures occurred.One case had re-dislocation of the acromioclavicular joint due to postoperative trauma and underwent open reduction and revision.The average operation time was(62.34±13.76)min.UCLA score improved from preoperative(14.47±2.59)points to(26.87±1.37)points;CMS improved from(74.40±3.92)points to(93.07±2.22)points.The CCD was(21.34±1.32)mm before surgery,and(8.93±1.03)mm 6 months after surgery,and the difference was statistically significant.Conclusion The arthroscopic Triple TRUE-button technique for treating acromioclavicular joint dislocation can achieve satisfactory short-term clinical efficacy,but its long-term efficacy still needs to be observed.