改良带袢钛板悬吊固定治疗肩锁关节脱位的近中期疗效

Short-term and medium-term efficacy of modified loop plate suspension fixation in the treatment of acromioclavicular joint dislocation

目的探讨改良带袢钛板悬吊固定治疗肩锁关节脱位的近中期疗效。方法回顾性收集2020年12月至2022年12月扬州市中医院收治的72例肩锁关节脱位患者的临床资料,依据治疗术式分为改良组(n=37)和传统组(n=35)。改良组行改良带袢钛板悬吊固定;传统组行锁骨钩钢板固定。比较两组患者围手术期指标,术后并发症发生率,术后6个月肩关节功能恢复优良率,术前、术后3个月、术后6个月Constant-Murley评分、肩关节活动度、疼痛视觉模拟量表(visual analogue scale,VAS)评分。结果改良组患者切口长度、恢复工作时间短于传统组(P<0.001),术中出血量少于传统组(P<0.001)。两组患者术后3个月、术后6个月Constant-Murley评分、肩关节前屈及外展活动度均大于术前(P<0.05),且改良组改善更明显(P<0.05)。两组患者术后3个月、术后6个月VAS评分均低于术前(P<0.05),且改良组改善更明显(P<0.05)。两组患者术后6个月肩关节功能恢复优良率和术后并发症发生率差异无统计学意义。结论改良带袢钛板悬吊固定用于治疗肩锁关节脱位可减轻手术创伤及术后疼痛,并促进患者肩关节功能恢复。

Objective To explore the short-term and medium-term efficacy of modified loop plate suspensionfixation in the treatment of acromioclavicular joint dislocation.Methods A retrospective analysis was performed in 72 patients with acromioclavicular joint dislocation and treated in Yangzhou Hospital of Traditional Chinese Medicine from December 2020 to December 2022.The patients were divided into modified group(n=37)and traditional group(n=35)according to different surgical methods.The modified group was treated with modified loop plate suspensionfixation,and the traditional group was treated with clavicular hook plate fixation.The perioperative indexes,Constant-Murley score,and shoulder joint mobility and pain visual analogue scale(VAS)score before operation,3 months and 6 months after operation,postoperative complications rates,excellent and good rate of shoulder joint function recovery at 6 months after operation were compared between the two groups.Results The incision length and recovery time in the modified group were significantly shorter than those in the traditional group(P<0.001),and the intraoperative blood loss was significantly less than that in the traditional group(P<0.001).The Constant-Murley score,shoulderflexion and abduction activity in both groups at 3 months and 6 months after operation were significantly higher than before operation(P<0.05),and these improvements were greater in the modified group(P<0.05).The VAS scores of the two groups at 3 months and 6 months after operation were significantly lower than before operation(P<0.05),and these decreases were greater in the improved group(P<0.05).There were no significant differences in the excellent and good rate of shoulder joint function recovery and the incidence of postoperative complications between the two groups.Conclusions The modified titanium loop plate suspensionfixation in the treatment of acromioclavicular joint dislocation can reduce surgical trauma and postoperative pain,and promote the recovery of shoulder joint function.