改良TightRope袢钢板解剖重建喙锁韧带治疗RockwoodⅢ~Ⅴ型肩锁关节脱位

Coracoclavicular ligament anatomical reconstruction with modified TightRope loop plates in treatment of RockwoodⅢ-Ⅴacromioclavicular dislocation

目的观察改良TightRope袢钢板解剖重建喙锁韧带治疗RockwoodⅢ~Ⅴ型肩锁关节脱位的临床疗效。方法回顾性分析自2021-08—2022-10利用改良TightRope袢钢板解剖重建喙锁韧带治疗的35例RockwoodⅢ~Ⅴ型肩锁关节脱位,记录患者术后并发症发生情况及对手术疗效的总体主观满意度,比较患者手术前后Constant-Murley肩关节功能评分。结果所有患者均获得随访,随访时间12~18个月,平均14.34个月。术后1例出现肩关节复位丢失、肩锁关节半脱位情况,予以悬吊固定、延迟康复锻炼后疼痛明显缓解。所有患者均无切口感染、肩关节活动受限、肩关节疼痛及内固定失效等情况发生,总体并发症发生率为2.86%。末次随访时Constant-Murley肩关节功能评分为(95.23±1.47)分,较术前的(24.58±2.04)分明显增加,差异有统计学意义(t=1.97,P=0.03)。患者对手术疗效的总体主观满意度为:优20例,良12例,一般2例,差1例,优良率为91.43%。结论改良TightRope袢钢板解剖重建喙锁韧带治疗RockwoodⅢ~Ⅴ型肩锁关节脱位的疗效满意,可最大限度恢复肩锁关节的生物力学,降低患者术后肩关节疼痛、复位丢失、内固定失效等并发症发生率并提高患者总体满意度,值得临床推广应用。

Objective To observe the clinical effect of anatomical reconstruction of the coracoclavicular ligament with modified TightRope loop plates in the treatment of RockwoodⅢ-Ⅴacromioclavicular dislocation.Methods A retrospective analysis was performed on 35 cases of RockwoodⅢ-Ⅴacromioclavicular dislocation treated with modified TightRope loop plates from August 2021 to October 2022,and the incidence of postoperative complications and overall subjective satisfaction with the surgical effect were recorded.Constant-Murley shoulder joint function scores were compared before and after surgery.Results All patients were followed up for 12 to 18 months(mean 14.34 months).Loss of shoulder joint reduction and subluxation of the acromioclavicular joint occurred in 1 patient after operation.The pain was obviously relieved after suspension fixation and delayed rehabilitation exercise.No incision infection,shoulder joint mobility restriction,shoulder joint pain and internal fixation failure occurred in all patients,and the overall complication rate was 2.86%.The Constant-Murley shoulder joint function score at the last follow-up was(95.23±1.47),which was significantly higher than the preoperative score(24.58±2.04),and the difference was statistically significant(t=1.97,P=0.03).The overall subjective satisfaction of the patients with the surgical effect was excellent 20 cases,good 12 cases,fair 2 cases,poor 1 case,the excellent and good rate was 91.43%.Conclusion The modified TightRope loop plates anatomical reconstruction of coracoclavicular ligament in the treatment of RockwoodⅢ-Ⅴacromioclavicular joint dislocation has satisfactory efficacy,can maximize the recovery of acromioclavicular joint biomechanics,reduce the incidence of postoperative shoulder pain,loss of reduction,internal fixation failure and other complications,and improve the overall satisfaction of patients,which is worthy of clinical application.