Horst Klemens, Dienstknecht Thomas, Andruszkow Hagen, Gradl Gertraud, Kobbe Philipp, Pape Hans-Christoph
Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany.
Pol J Radiol. 2013 Oct;78(4):15-20. doi: 10.12659/PJR.889615. Epub 2013 Nov 19.
Operative treatment of higher degree acromioclavicular joint luxation is common. A new option is made available by the tight rope technique. It claims to provide adequate outcome with the use of a minimally invasive technique. First clinical studies justified its medical use, but the equivalence to established surgical methods remains unclear. We therefore analyzed radiographic data from patients that were treated with the tight rope system (TR) and compared them to those treated with K-wires (KW) fixation.
MATERIAL/METHODS: RETROSPECTIVE STUDY WITH INCLUSION CRITERIA: surgery for acromioclavicular joint luxation between 2004 and 2011, classified as Rockwood type III, no concomitant injury, first event injury. We compared pre- and post-operative X-rays with those taken at the end of treatment. Clinical data from follow-ups and radiographic data were evaluated. The main outcome variable was the remaining distance between the acromion and clavicle (ACD), as well as the coracoid process and clavicle (CCD).
27 patients (TR: n=16; KW: n=11) with comparable demographics and injury severity were included. Surgery reduced ACD (TR: p=0.002; KW: p<0.001) and CCD (TR: p=0.001; KW: p=0.003). Heterotopic ossification or postoperative osteolysis was not significantly associated with either one of the procedures. Three patients (18.75%) in the TR group showed impaired wound healing, migrating K-wires were recorded in 2 patients (18.2%) and impingement syndrome occurred in 1 patient (9.1%) with K-wires. Posttraumatic arthritis was not seen. There was a loss of reduction in 2 cases within the TR-group (12.51%) and 1 in the KW-group (9.1%). At last follow up, ACD and CCD were wider in both groups compared to the healthy side.
This study shows that the Tight rope system is an effective alternative in the treatment of higher degree acromioclavicular luxation and comparable to the established methods.
较高程度肩锁关节脱位的手术治疗很常见。紧绳技术提供了一种新的选择。它声称通过使用微创技术可获得足够的治疗效果。首批临床研究证明了其医学用途，但与既定手术方法的等效性仍不明确。因此，我们分析了接受紧绳系统（TR）治疗的患者的影像学数据，并将其与接受克氏针（KW）固定治疗的患者的数据进行比较。
材料/方法：符合纳入标准的回顾性研究：2004年至2011年间因肩锁关节脱位接受手术，Rockwood III型，无合并伤，首次受伤事件。我们比较了术前和术后X线片以及治疗结束时拍摄的X线片。对随访的临床数据和影像学数据进行了评估。主要结局变量是肩峰与锁骨之间的剩余距离（ACD）以及喙突与锁骨之间的距离（CCD）。
纳入了27例人口统计学特征和损伤严重程度相当的患者（TR组：n = 16；KW组：n = 11）。手术使ACD（TR组：p = 0.002；KW组：p < 0.001）和CCD（TR组：p = 0.001；KW组：p = 0.003）减小。异位骨化或术后骨质溶解与这两种手术方法均无显著相关性。TR组有3例患者（18.75%）伤口愈合受损，KW组有2例患者（18.2%）出现克氏针移位，1例患者（9.1%）出现克氏针撞击综合征。未观察到创伤后关节炎。TR组有2例（12.51%）出现复位丢失，KW组有1例（9.1%）出现复位丢失。在最后一次随访时，两组的ACD和CCD均比健侧更宽。
本研究表明，紧绳系统是治疗较高程度肩锁关节脱位的一种有效替代方法，与既定方法相当。
Zotero 插件
