| 肩锁韧带加强缝合联合锁骨钩钢板及喙锁韧带修复治疗肩锁关节脱位的对比研究 |
| A comparative study about strengthened suture of the acromioclavicular ligament combined with clavicular hook plate and repair of coracoclavicular ligament for acromioclavicular joint dislocation treatment |
| 投稿时间：2024-04-10 |
| DOI：10.3969/j.issn.1672-5972.2025.01.007 |
| 中文关键词: 肩锁关节脱位 锁骨钩钢板 喙锁韧带 肩锁韧带 |
| 英文关键词:Acromioclavicular joint dislocation Clavicular hook plate Coracoclavicular ligament Acromioclavicular ligament |
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| 中文摘要: |
| 目的 探讨锁骨钩钢板固定及喙锁韧带修复基础上增加肩锁关节固定对肩锁关节脱位疗效的影响。方法 回顾性分析2017年2月至2022年2月中国人民解放军联勤保障部队第九〇一医院收治的64例急性肩锁关节脱位患者的临床资料，其中锁骨钩钢板+喙锁韧带缝合锚加强修复组（CC修复组）31例，锁骨钩钢板+喙锁韧带缝合锚加强修复+肩锁关节加强固定组（CC/AC修复组）33例。比较两组患者的术中出血量、手术时长，并将两组患者术后1、3、6个月视觉模拟疼痛评分（VAS）及Constant-Murley肩关节功能评分进行对比。锁骨钩钢板取出前CT检查评估两组患者锁骨远端与肩峰对位情况。结果 64例患者随访时间均大于10个月，平均随访（11.61±1.27）个月。两组的术中出血量比较，差异无统计学意义（P＞0.05）；而手术时长方面，CC/AC修复组多于CC修复组（P＜0.05）。不同时间节点上VAS疼痛评分及Constant-Murley评分，两组间比较差异无统计学意义（P＞0.05）。两组在肩锁关节上下位移方面，差异无统计学意义（P＞0.05）；但CC/AC修复组在恢复肩锁关节前后向对位及内外侧方对位方面优于CC修复组（P＜0.05）。结论 肩锁韧带加强缝合联合锁骨钩钢板及喙锁韧带修复对恢复肩锁关节的对位更具优势，治疗效果满意。 |
| 英文摘要: |
| Objective To explore the effect of strengthened suture of the acromioclavicular ligament on the treatment of acromioclavicular joint dislocation employing clavicular hook plate combined with suture anchor for coracoclavicular ligament repair.Methods We analyzed the clinical data of 64 patients with acute acromioclavicular dislocation who were admitted to the 901th Hospital of the Joint Logistics Support Force of PLA between February 2017 and February 2022. They were divided into the group with clavicle hook plate and strengthened repair of coracoclavicular ligament suture anchor (CC repair group, n=31) and the group with clavicle hook plate and strengthened repair of coracoclavicular ligament suture anchor as well as reinforced fixation of acromioclavicular joint (CC/AC repair group, n=33). We compared the visual analogue scale (VAS) and Constant-Murley shoulder joint function score at the mentioned points, along with the intraoperative bleeding volume and surgical time between the two patient groups. Examined the position of the distal clavicle and acromion in both groups of patients using a CT scan before removing the clavicle hook steel plate.Results All patients were followed up for more than 10 months, with an average follow-up time of (11.61±1.27) months. The difference in intraoperative blood loss between the two groups was not statistically significant (P>0.05), while the surgical duration in the CC/AC repair group was longer than that in the CC repair group (P<0.05). The differences between VAS and Constant-Murley score at different time points was of no statistical significance (P>0.05). The CC/AC repair group had significant advantages in the anteroposterior and lateral alignment of the acromioclavicular joint than those in the CC repair group (P<0.05), while the difference between the upper and lower displacement did not reach the statistical significance (P>0.05).Conclusion Strengthened suture of the acromioclavicular ligament combined with a clavicle hook plate and repair of the coracoclavicular ligament has a higher priority in restoring the alignment of the acromioclavicular joint, with a more satisfactory treatment effect. |
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