带线锚钉解剖重建喙锁韧带与肩锁韧带治疗肩锁关节脱位的临床疗效
| 作者: |
1方闰,
1宁仁德,
1吴世桐
1 安徽医科大学第三附属医院骨科，合肥 230061 |
| 通讯: |
宁仁德
Email: nrd192@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.06.020 |
摘要
目的：观察带线锚钉解剖重建喙锁韧带及肩锁韧带治疗Rockwood III型及以上肩锁关节脱位的临床疗效。方法：回顾2015年9月至2017年6月对22例Rockwood III型及以上肩锁关节脱位行切开复位带线锚钉内固定结合韧带修复治疗，其中Rockwood III型14例，IV型5例，V型3例；男14例，女8例；左侧12例，右侧10例；年龄18~70(平均39.88)岁。平地摔伤10例，车祸伤7例，高处坠落伤5例，受伤距手术时间3~7 d。结果：22例患者均获得随访，随访时间12~15(平均13.5)个月。手术时间(48.45±8.25) min，术中出血量(57.23±6.32) mL，切口均甲级愈合，均无锁骨下血管、神经损伤，无内固定松动及脱出，无锁骨及喙突骨折等。术后1年X线复查肩锁关节位置良好，锚钉位置正常，术后3 d，3个月，6个月，12个月喙锁间距与肩锁关节间隙比较，差异无统计学意义(P>0.05)。术后3个月Constant-Murley肩关节评分(94.55±1.77)明显高于术前(21.55±2.39)，差异有统计学意义(t=150.98，P<0.05)；术后1年(94.90±1.48)较术后3个月无明显变化，差异无统计学意义(t=1.56，P>0.05)。结论：应用带线锚钉内固定治疗Rockwood III型及以上肩锁关节脱位手术创伤小，操作简单，固定牢固，无需二次手术，患者术后肩关节功能恢复良好。
关键词：
带线锚钉；Rockwood III型；肩锁关节脱位
Clinical effects of anatomical reconstruction of coracoclavicular ligament and acromioclavicular ligament with suture anchor in the treatment of acromioclavicular dislocation
CorrespondingAuthor: NING Rende Email: nrd192@qq.com
DOI: 10.3978/j.issn.2095-6959.2019.06.020
Abstract
Objective: To observe the effect of anatomical reconstruction of coracoclavicular ligament and acromioclavicular ligament with suture anchor on Rockwood III and above acromioclavicular dislocation. Methods: Twenty-two acromioclavicular dislocation patients were retrospectively reviewed from September 2015 to June 2017, which were treated with open reduction and internal fixation with suture anchor and ligamentum repair, including 14 cases of Rockwood III, 5 cases of IV, 3 cases of V, 14 cases of male and 8 cases of female. Left 12, right 10, 22 patients were aged from 18 to 70 years (mean 39.88 years). There were 10 cases of falling injury, 7 cases of traffic accident injury and 5 cases of fall accident from high place injury. The time of injury was 3 to 7 days. Results: All the 22 patients were followed up for 12 to 15 months (mean 13.5 months). The operative time was (48.45±8.25) min. The amount of bleeding during operation was (57.23±6.32) mL. All the incisions healed in grade A, no subclavian vessels or nerve injury, no loosening of internal fixation, no fracture of clavicle and coracoid process, and so on. One year after operation, X-ray reexamination showed that the position of acromioclavicular joint was good, and the position of anchor was normal. There was no significant difference between coracoclavicular space and acromioclavicular joint space in 3 days, 3 months, 6 months and 12 months after operation (P>0.05). The Constant-Murley’s shoulder joint score of 3 months (94.55±1.77) after operation was significantly higher than that of preoperative (21.55±2.39), the difference was statistically significant (t=150.98, P<0.05), the score of 1 year (94.90±1.48) after operation had no significant change compared with that of 3 months after operation, and the difference was not statistically significant (t=1.56, P>0.05). Conclusion: The treatment of Rockwood III and above acromioclavicular dislocation by internal fixation with suture anchor has the advantages of small trauma, simple operation, firm fixation, no need for secondary operation, and good recovery of shoulder joint function after operation.
Keywords：
suture anchor; Rockwood III; acromioclavicular dislocation