Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK.
J Orthop Traumatol. 2011 Mar;12(1):19-27. doi: 10.1007/s10195-011-0127-1. Epub 2011 Feb 23.
Whilst there is little debate over the treatment of Rockwood grade V and VI acromioclavicular dislocation, the management of grade III acromioclavicular dislocation remains less clear. The purpose of this study was to compare the clinical outcomes of patients managed operatively and non-operatively following grade III acromioclavicular dislocation.
A systematic review of published and unpublished material was conducted. All included studies were reviewed against the PEDro appraisal tool. Where appropriate, a meta-analysis of pooled results was conducted.
Among 724 citations, six studies met the eligibility criteria. All six studies were retrospective case series (level 4 evidence). The findings of this study indicated that operative management of grade III acromioclavicular dislocation results in a better cosmetic outcome (P < 0.0001) but greater duration of sick leave compared to non-operative management (P < 0.001). There was no difference in strength, pain, throwing ability and incidence of acromioclavicular joint osteoarthritis compared to non-operative management. Only one study recorded and showed a higher Constant score for operative management compared to non-operative management (P = 0.003).
There is a lack of well-designed studies in the literature to justify the optimum mode of treatment of grade III acromioclavicular dislocations.
虽然对于 Rockwood 等级 V 和 VI 肩锁关节脱位的治疗方法几乎没有争议，但对于等级 III 肩锁关节脱位的治疗方法仍存在争议。本研究的目的是比较手术和非手术治疗等级 III 肩锁关节脱位患者的临床结果。
对已发表和未发表的资料进行了系统的回顾。所有纳入的研究均根据 PEDro 评估工具进行了评估。在适当的情况下，对汇总结果进行了荟萃分析。
在 724 条引文中，有 6 项研究符合入选标准。这 6 项研究均为回顾性病例系列研究（证据等级 4）。本研究的结果表明，手术治疗等级 III 肩锁关节脱位的美容效果更好（P < 0.0001），但病假时间比非手术治疗更长（P < 0.001）。与非手术治疗相比，在力量、疼痛、投掷能力和肩锁关节骨关节炎的发生率方面没有差异。只有一项研究记录并显示手术治疗的 Constant 评分高于非手术治疗（P = 0.003）。
文献中缺乏设计良好的研究来证明等级 III 肩锁关节脱位的最佳治疗方法。
