Wang Yeming, Zhang Jianguo
Department of Orthopaedics, Tianjin Hospital, Tianjin, China.
Department of Orthopaedics, Tianjin Hospital, Tianjin, China.
Injury. 2014 Jun;45(6):949-54. doi: 10.1016/j.injury.2013.12.013. Epub 2014 Jan 10.
Various techniques have been reported for the treatment of chronic acromioclavicular (AC) joint separation. The purpose of this study was to evaluate the results of surgical construction of coracoclavicular ligament using coracoid process transfer augmented with a hook plate fixation.
Twenty-one patients treated with coracoid process transfer augmented with a hook plate fixation for chronic type III and V AC injuries were retrospectively analysed in 2003-2009. The age of the patients ranged from 23 to 58 years with an average age of 41.6 years. The patients were followed up clinically and radiographically, with an average of 33.0 months. Functional status and the ability to return to work were recorded during follow-up. Constant score and visual analogue scale (VAS) for pain were measured.
The mean Constant score has increased from 70.9 points preoperatively to 90.7 points at follow-up. The mean VAS score has decreased from 4.7 preoperatively to 1.2 at follow-up. The average abduction was 172°, forward flexion was 170° and external rotation was 56°. There were 10 excellent results, 10 good results and one fair result. All patients had resumed their job or returned to original sport activity at mean 3.7 months postoperatively. No reduction loss was observed after plate removal and the final follow-up.
Despite retrospective nature of the study, the outcomes of surgical construction with process transfer augmented with hook plate fixation are promising for chronic type III and V AC injuries.
Therapeutic level IV. Retrospective case series, treatment study.
已有多种治疗慢性肩锁关节分离的技术报道。本研究旨在评估采用喙突移位加钩钢板固定来重建喙锁韧带的手术效果。
回顾性分析2003年至2009年采用喙突移位加钩钢板固定治疗的21例慢性III型和V型肩锁关节损伤患者。患者年龄在23至58岁之间，平均年龄41.6岁。对患者进行临床和影像学随访，平均随访33.0个月。随访期间记录功能状态和恢复工作的能力。测量Constant评分和疼痛视觉模拟量表（VAS）。
Constant评分均值从术前的70.9分提高到随访时的90.7分。VAS评分均值从术前的4.7分降至随访时的1.2分。平均外展角度为172°，前屈角度为170°，外旋角度为56°。结果为优的有10例，良的有10例，尚可的有1例。所有患者术后平均3.7个月恢复工作或恢复原来的体育活动。钢板取出后及末次随访时未见复位丢失。
尽管本研究为回顾性研究，但采用喙突移位加钩钢板固定进行手术重建治疗慢性III型和V型肩锁关节损伤的效果令人满意。
治疗性IV级。回顾性病例系列，治疗研究。
