应用异体肌腱重建喙锁韧带治疗肩锁关节完全脱位

Treatment of Completely Dislocated Acromioclavicular Joint by Allogenic Tendon Repair of Coracoclavicular

目的 :探索应用异体肌腱重建喙锁韧带治疗肩锁关节完全脱位一种新的手术方法。方法 :从 1997年 10月2 0 0 1年 12月 ,共 2 1例肩锁关节完全脱位患者 ,接受了经过深低温处理的同种异体屈指肌腱 ,采用在喙锁韧带位置 ,穿过软组织隧道 ,行编织缝合 ,进行立体“8”字重建的治疗方法 ,恢复喙锁韧带在垂直方向对肩锁关节的稳定。在 2 1例接受此治疗方法患者中 ,有 19例得到了 1年以上的随访。随访时间 12 40个月 ,平均 16 .8个月。结果 :采用Lazzcano和Karlsson综合评分标准 ,优 15例 ,良 4例。X线片显示重建喙锁韧带部分骨化者 2例。结论 :异体肌腱重建喙锁韧带治疗肩锁关节完全脱位可以避免自体取材造成的副损伤及其引起的并发症 ,供材可提前制作 ,缩短了手术时间 ,减少了自体创伤。在组织工程移植尚未完全获得成功的今天 ,是一种可行的手术方法。

Objective: To evaluate the preliminary result of clinical application in the treatment of completely dislocated acromioclavicular joint by allogenic tendon repair of coracoclavicular ligament. Methods:From Oct. 1997 to Dec. 2001,21cases of completely dislocated acromioclavicular joint were treated with allogeneic flexor tendon to repair the coracoclavicular ligament, which was stored in deep hypothermia. Reconstruct it through tissue hole,in the direction of coracoclavicular ligament fibers,using double-S inter-crossing way. The allogenic flexor tendons were used to rebuild the coracoclavicular ligament for vertical stability of the acromioclavicular joint. Results: Nineteen cases were followed up from 12 to 40 months,averaged 16.8 months. Evaluated according to the criteria of Lazzcano and Karlsson, 15 out of 19 cases got excellent result and 4 good. Conclusion:Allogenic tendon repair of coracoclavicular for treatment completely dislocated acromioclavicular joint is effective. It coud be procured before operation, and avoid the injury and complication caused by the autograft. It is effective when the artification tendon produced with tissue engineering was not completely succeed.