Grassbaugh Jason A, Cole Chad, Wohlrab Kurt, Eichinger Josef
Department of Orthopedics, Womack Army Medical Center, Fort Bragg, NC, USA.
J Surg Orthop Adv. 2013 Spring;22(1):71-6. doi: 10.3113/jsoa.2013.0071.
Optimal treatment for acromioclavicular (AC) dislocation is unknown. Numerous surgical procedures for AC injuries have been described with little comparison. This study sought to compare the clinical and radiographic results of various surgical techniques in order to identify the optimal surgical technique. Ninety patients met inclusion criteria of AC reconstruction at this institution. A retrospective review of outcomes was performed using the electronic records system. Radiographs were measured for pre- and postoperative grade and percent elevation versus the contralateral side. Overall revision rate was 9%. Suture button fixation had a revision rate of 0% compared to 14% (p = .01). Reconstruction procedures performed with distal clavicle excision showed a higher revision rate, 17% compared to 0% (p = .003). There were no statistically significant clinical differences. AC reconstructions performed with suture button construct were superior to other surgical techniques. Procedures performed with distal clavicle excision were inferior to those without.
肩锁关节(AC)脱位的最佳治疗方法尚不清楚。针对AC损伤的众多外科手术方法已被描述,但对比很少。本研究旨在比较各种外科技术的临床和影像学结果,以确定最佳外科技术。90例患者符合该机构AC重建的纳入标准。使用电子记录系统对结果进行回顾性分析。测量术前和术后与对侧相比的分级和抬高百分比的X线片。总体翻修率为9%。缝线纽扣固定的翻修率为0%,而其他方法为14%(p = 0.01)。采用锁骨远端切除术的重建手术显示出更高的翻修率,为17%,而其他方法为0%(p = 0.003)。临床差异无统计学意义。采用缝线纽扣结构进行的AC重建优于其他外科技术。采用锁骨远端切除术的手术效果不如未采用该方法的手术。