改良徒手法锁扣带袢钛板微创手术治疗肩锁关节脱位

Minimally invasive treatment of acromioclavicular joint dislocation with Tight Rope by modified technique bare-handed

目的:探讨改良徒手法锁扣带袢钛板微创治疗肩锁关节脱位的方法及临床疗效。方法:对本院2018年6月至2021年11月期间采用改良徒手法锁扣带袢钛板微创内固定治疗的61例肩锁关节脱位病例进行回顾性分析,男35例、女26例,年龄45.6±5.2岁。根据Tossy分型,TossyⅡ型21例、TossyⅢ型40例。采用Karlsson标准进行疗效评价,应用牛津肩关节评分、Constant-Murley评分评价肩关节功能。结果:所有患者均获随访,随访时间为9~12个月,平均11.2月,60例肩锁关节脱位复位未丢失。按Karlsson标准评价疗效:优60例,差1例,优良率98.36%。末次随访时,Constant-Murley评分95.65±2.32分,牛津肩关节评分12.92±0.81分,均较术前显著改善(P<0.01),满意度为96.74%。结论:采用改良徒手法锁扣带袢钛板内固定治疗肩锁关节脱位,微创、固定稳定、复位不易丢失、不干扰肩锁关节及肩峰下结构、术后肩关节功能良好,效果满意。

Objective To explore the method and the clinical effect of minimally invasive treating acromioclavicular joint dislocation by modified technique bare-handed Tight Rope.Methods A retrospective analysis was performed on 61 cases of acromioclavicular joint dislocation(35 males and 26 females,aged 45.6±5.2 years),treated with minimally invasive internal fixation by modified technique bare-handed Tight Rope between June 2018 and November 2021 in our hospital.According to Tossy classification,21 of them were TossyⅡand 40 were TossyⅢ.The clinical effect was evaluated by Karlsson criteria,and the shoulder function was assessed by using the Oxford shoulder joint and Constant-Murley scores.Results All patients were followed up 9~12 months(11.2 months on the average).Sixty of them were restored without re-dislocation,reaching 60 of excellence and an excellence rate of98.36%.At the last follow-up,the Constant-Murley and Oxford shoulder joint scores were 95.65±2.32 and 12.92±0.81,both significantly better than before surgery(P<0.01),with the satisfaction rate of 96.74%.Conclusion The treatment of acromioclavicular joint dislocation with modified technique bare-handed Tight Rope is minimally invasive,stable,not easy to relocate,and friendly to acromioclavicular joint and subacromial structure.Moreover,the shoulder joint function is well-recovered after the surgery with satisfactory effect.