关节镜下带袢双钢板技术治疗Rockwood Ⅲ型以上 肩锁关节脱位的疗效评估

Arthroscopically assisted double Endobutton fixation technique in treatment of acute acromioclavicular joint dislocation

摘要:

摘要：目的??探讨关节镜下带袢双钢板技术治疗Rockwood Ⅲ型及以上的急性肩锁关节脱位的临床疗效。方法?收集并分析绵阳市第三人民医院骨一科收治的12例急性肩锁关节脱位患者的临床资料。其中，男8例，女4例，Rockwood分型Ⅲ型4例、Ⅳ型4例、Ⅴ型3例、Ⅵ型1例，所有患者均采用关节镜下带袢双钢板技术治疗，对术前和末次随访疼痛视觉模拟评分（VAS）和Constant评分进行统计分析。同时拍摄双肩关节正位片，了解复位稳定情况。结果?术后平均随访5个月（3～18个月），受伤至手术时间3.70 d（2～6 d），术前VAS评分平均5.62分（4～6分），术后平均1.20分（0～2）分；术前Constant评分平均29.14分（13～40分），术后平均91.24分（72～100分）。所有患者术后VAS和Constant评分明显优于术前（P <0.01）。根据Constant评分为优10例，良2例。结论?关节镜结合带袢双钢板技术治疗Ⅲ型以上肩锁关节脱位创伤小，可处理合并疾患，能有效提高患者预后，是目前临床上值得推广的方案。

Abstract:

Abstract: Objective?To analyze the clinical effect of arthroscopically assisted double button plate reconstruction of coracoclavicular ligament in treatment of Rockwood Ⅲ, Ⅳ, Ⅴ and Ⅵ acute acromioclavicular joint dislocation.?Methods?From March 2016 to March 2017, 12 patients with Rockwood type Ⅲ, Ⅳ, Ⅴ, VI, shoulder joint dislocation were included, all these cases were treated by arthroscopic double Endobutton fixation technique. Patients were followed up for 3 to 18 months. The changes of VAS score, and Constant score of acromioclavicular joint in both perioperative and postoperative were recorded.?Results?The mean follow-up time was 5 months (range from 3 to 18 months), and mean time from injury to surgery was 3.70 days (2 ~ 6 days). The therapeutic effects were achieved in all patients after the arthroscopically assisted double button plate reconstruction. All the measurements, including the mean forward elevation VAS scores before 5.62 (range, 4 ~ 6) and after fixation 1.20 (range, 0 ~ 2), and mean Constant scores before 29.14 (range, 13 ~ 40) and after fixation 91.24 (range, 72 ~ 100), improved significantly (P < 0.01) after the treatment.?Conclusion?Arthroscopic double button fixation technique is a minimally invasive way to deal with the associate injuries of the shoulder, and achieve an excellent effect in the treatment of acute acromioclavicular joint dislocation.