双TightRope带袢钢板与锁骨钩钢板内固定治疗急性肩锁关节脱位的疗效比较

Comparison of clinical efficacy between double TightRope plate and clavicle hook plate internal fixation in treatment of acute acromioclavicular joint dislocation

目的比较双TightRope带袢钢板与锁骨钩钢板内固定治疗急性肩锁关节脱位的临床疗效,总结手术治疗体会。方法回顾性分析自2019-05—2022-10手术治疗的40例RockwoodⅢ~Ⅴ型急性肩锁关节脱位,其中20例采用双TightRope带袢钢板内固定治疗(TightRope组),20例采用锁骨钩钢板内固定治疗(锁骨钩钢板组)。比较两组手术时间、术中出血量、住院时间、并发症发生率,以及术后12个月疼痛VAS评分、前屈上举活动度、外展上举活动度、肩关节功能Constant-Murley评分。结果40例均获得随访,随访时间为12~18个月,平均15个月。TightRope组与锁骨钩钢板组术中出血量、住院时间差异无统计学意义(P>0.05)。TightRope组手术时间较锁骨钩钢板组长,术后并发症发生率低于锁骨钩钢板组,术后12个月疼痛VAS评分低于锁骨钩钢板组,术后12个月前屈上举活动度、外展上举活动度大于锁骨钩钢板组,术后12个月肩关节功能Constant-Murley评分高于锁骨钩钢板组,差异有统计学意义(P<0.05)。结论与锁骨钩钢板内固定相比较,小切口双TightRope带袢钢板内固定治疗肩锁关节脱位可以解剖重建喙锁韧带,具有固定效果好、并发症少、肩关节功能恢复快、无需二次手术取出内固定物等优点。

Objective To compare the clinical efficacy between TightRope plate and clavicle hook plate internal fixation in the treatment of acute acromioclavicular joint dislocation,and summarize the surgical experience.Methods A retrospective analysis was conducted on 40 cases of RockwoodⅢ-Ⅴacute acromioclavicular joint dislocation treated surgically from May 2019 to October 2022,including 20 cases treated with TightRope plate internal fixation(TightRope group)and 20 cases with clavicle hook plate internal fixation(CHP group).Surgical time,intraoperative blood loss,length of hospital stay,incidence of complications,as well as pain VAS score,forward elevation range,abduction range,and Constant-Murley score of shoulder joint function at 12 months postoperatively were compared between the two groups.Results Forty patients were followed up for 12 to 18 months,with an average follow-up time of 15 months.There was no statistically significant difference in intraoperative blood loss and length of hospital stay between the TightRope group and the CHP group(P>0.05).Compared to the CHP group,the TightRope group had longer surgical time,lower incidence of postoperative complications,lower pain VAS score at 12 months postoperatively,greater forward elevation range and abduction range at 12 months postoperatively,and higher shoulder joint function Constant-Murley score at 12 months postoperatively,with statistically significant differences(P<0.05).Conclusion Compared with clavicle hook plate internal fixation,small incision TightRope plate internal fixation for the treatment of acromioclavicular joint dislocation can anatomically reconstruct the coracoclavicular ligament,which has the advantages of good fixation effect,fewer complications,quicker recovery of shoulder function,and no need for a second surgery to remove internal fixation.