CAJ | 학술논문

目的探讨同种异体肌腱结合带线锚钉重建喙锁韧带治疗急性肩锁关节脱位的手术治疗方法和临床疗效.方法对2009年1月至2012年5月收治的17例急性肩锁关节脱位病例进行回顾性研究,按照Rockwood分型:Ⅲ型10例,Ⅳ型2例,Ⅴ型5例.术后根据Constant-Murley评分及影像学评估临床疗效.结果所有患者均获得12～26个月的随访,平均16.3个月.所有患者恢复正常工作生活.末次随访时患侧Constant-Murley评分平均为(93.70±1.85)分,健侧平均为(95.80±1.18)分,两者差异无统计学意义(t=0.640,P=0.43).术前测量肩关节正位片喙锁间隙距离平均为(14.02±1.98)mm,术后即刻为(8.32±0.46)mm,末次随访时为(8.49±0.48)mm.术后即刻和末次随访时喙锁间隙距离与术前比较差异有统计学意义(t=12.984,P=0.000),术后即刻与末次随访时喙锁间隙距离差异无统计学意义(t=-5.821,P=0.24).无感染、血管神经损伤及内固定失效等并发症.结论同种异体肌腱结合带线锚钉重建喙锁韧带治疗急性肩锁关节脱位临床疗效良好.
목적 탐토동충이체기건결합대선묘정중건훼쇄인대치료급성견쇄관절탈위적수술치료방법화림상료효.방법 대2009년1월지2012년5월수치적17례급성견쇄관절탈위병례진행회고성연구,안조Rockwood분형:Ⅲ형10례,Ⅳ형2례,Ⅴ형5례.술후근거Constant-Murley평분급영상학평고림상료효.결과 소유환자균획득12～26개월적수방,평균16.3개월.소유환자회복정상공작생활.말차수방시환측Constant-Murley평분평균위(93.70±1.85)분,건측평균위(95.80±1.18)분,량자차이무통계학의의(t=0.640,P=0.43).술전측량견관절정위편훼쇄간극거리평균위(14.02±1.98)mm,술후즉각위(8.32±0.46)mm,말차수방시위(8.49±0.48)mm.술후즉각화말차수방시훼쇄간극거리여술전비교차이유통계학의의(t=12.984,P=0.000),술후즉각여말차수방시훼쇄간극거리차이무통계학의의(t=-5.821,P=0.24).무감염、혈관신경손상급내고정실효등병발증.결론 동충이체기건결합대선묘정중건훼쇄인대치료급성견쇄관절탈위림상료효량호.
Objective To investigate the surgical techniques and clinical outcomes of treating acute acromioclavicular(AC) joint dislocations with coracoclavicular (CC) ligament reconstruction using allogeneic tendon graft and suture anchors.Methods From January 2009 to May 2012,17 patients with acute AC joint dislocation were treated in our department using allogeneic tendon graft reconstruction of the CC ligament combined with suture anchors.According to Rockwood classification,there were 10 cases of type Ⅲ,2 cases of type Ⅳ,and 5 cases of type Ⅴ.The Constant-Murley score and radiographs were used to assess surgical outcomes.Results All the patients were follow-up for 12 to 26 months,with an average of 16.3 months.All patients maintained their previous jobs and normal daily activities of living.The mean Constant-Murley score at the last follow-up was (93.70 ± 1.85) points on the injured side and (95.80 ± 1.18) points on the uninjured contralateral side.There was no statistically significant difference(t =0.640,P =0.43).The mean CC distance measured on the anteroposterior shoulder X-rays was (14.02 ± 1.98) mm before the surgery,(8.32 ± 0.46) mm immediately after the surgery and (8.49 ± 0.48) mm at last follow-up.The preoperative and postoperative CC distances were significantly different (t =12.984,P =0.000),while no significant difference was observed between immediate postoperative CC distance and CC distance at last follow-up (t =-5.821,P =0.24).There were no wound infection,neurovascular injury,implant loosening or other severe complications.Conclusion CC ligament reconstruction using suture anchors and allogenetic tendon graft in acute complete AC dislocation is a reliable technique for restoring stability to the AC joint.