Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Am J Sports Med. 2010 May;38(5):950-7. doi: 10.1177/0363546509356976. Epub 2010 Mar 12.
Over 60 repair/reconstruction techniques have been described for the treatment of coracoclavicular (CC) ligament injuries.
To report the functional and radiological outcomes of single-tunnel CC ligament reconstruction using autogenous semitendinosus tendon.
Case series; Level of evidence, 4.
Between August 2005 and January 2008, a total of 21 patients, 16 patients (14 men, 2 women) with a Rockwood type IV, type V, or a chronic type III acromioclavicular (AC) dislocation and 5 patients (4 men, 1 woman) with a painful nonunited distal clavicle fracture with CC separation, underwent CC reconstructive surgery using a semitendinosus autograft. All 21 patients were followed up clinically and radiographically. The mean follow-up was 33 months (range, 18-47), and the mean patient age was 39.8 years (range, 18-70). Chronic type III AC dislocations and nonunited distal clavicle fractures with CC separation were scored using preoperative AC scoring (AC Joint Separation Questionnaire). Constant, University of California-Los Angeles (UCLA), and AC scores were evaluated for all patients at final follow-up.
At the final follow-up, 10 patients achieved an "excellent" result and 11 a "good" result according to the AC scoring scheme. Mean final Constant and UCLA scores were 84.7 (range, 67-94) and 30.0 (range, 23-35), respectively. In the antero-posterior (AP) plane, 17 (81%) of the 21 patients maintained complete reduction, and 1 of the remaining 4, a manual laborer, had complete reduction loss. Of the 17 patients with an axillary view at final follow-up, 1 patient (5.9%) showed partial subluxation, although no subluxation was observed in the AP radiograph. The other 16 patients (94.1%) had a complete reduction state in axillary view.
Single-tunnel CC reconstruction with an autogenous hamstring tendon graft after a mean follow-up of 33 months (range, 18-47) appears to be a satisfactory means of treating acute Rockwood type IV, V, chronic type III, and painful nonunited distal clavicle fractures with CC separation.
已有超过 60 种修复/重建技术被用于治疗肩锁关节（CC）韧带损伤。
报告使用自体半腱肌腱进行单隧道 CC 韧带重建的功能和影像学结果。
病例系列；证据水平，4 级。
2005 年 8 月至 2008 年 1 月，共有 21 例患者接受了 CC 重建手术，其中 16 例（14 名男性，2 名女性）为 Rockwood 型 IV、V 型或慢性 III 型肩锁关节脱位，5 例（4 名男性，1 名女性）为伴有 CC 分离的疼痛性未愈合锁骨远端骨折。所有 21 例患者均接受了半腱肌腱自体移植的 CC 重建手术，并进行了临床和影像学随访。平均随访时间为 33 个月（范围，18-47 个月），平均患者年龄为 39.8 岁（范围，18-70 岁）。慢性 III 型肩锁关节脱位和伴有 CC 分离的未愈合锁骨远端骨折采用术前肩锁关节评分（肩锁关节分离问卷）进行评分。所有患者在末次随访时均进行了Constant、加州大学洛杉矶分校（UCLA）和肩锁关节评分。
根据肩锁关节评分方案，末次随访时 10 例患者为“优”，11 例为“良”。最终 Constant 和 UCLA 评分分别为 84.7（范围，67-94）和 30.0（范围，23-35）。在前后位（AP）平面，21 例患者中有 17 例（81%）维持了完全复位，其余 4 例（其中 1 例为体力劳动者）完全复位丢失。在末次随访时进行腋位 X 线检查的 17 例患者中，1 例（5.9%）出现部分半脱位，尽管在 AP 位 X 线片上未见半脱位。其余 16 例（94.1%）患者在腋位 X 线片上均处于完全复位状态。
在平均 33 个月（范围，18-47 个月）的随访后，使用自体肌腱重建单隧道 CC 韧带似乎是治疗急性 Rockwood 型 IV、V、慢性 III 型和伴有 CC 分离的疼痛性未愈合锁骨远端骨折的一种满意方法。
