改良双纽扣钢板技术治疗TossyⅢ型肩锁关节脱位的远期疗效分析

[Analysis on the long-term effects of modified double endobutton technique in the treatment of Tossy type III acromioclavicular joint dislocations].

作者信息

Yan Rui-Jian, Lu Jian-Wei, Zhang Chun

出版信息

Zhongguo Gu Shang. 2014 Jan;27(1):9-12.

Abstract

OBJECTIVE

To investigate the long-term clinical effects of modified double Endobutton technique for the treatment of acromioclavicular joint dislocations of Tossy type III.

METHODS

A retrospective study was done in 42 patients with acromioclavicular joint dislocations of Tossy type III treated with modified double Endobutton technique from December 2008 to December 2010. There were 24 males and 18 females, ranging in age from 21 to 56 years old (averaged, 32.5 years old). All the patients were treated with open reduction, coracoclavicular ligament reconstruction using double Endobutton technique, and repair of acromioclavicular ligament. The Karlsson system was used to evaluate therapeutic effects. The distance from coracoid to clavicle was measured to evaluate reduction loss.

RESULTS

All the patients were followed up, and the duration ranged from 2.0 to 3.2 years (averaged,2.4 years). According to Karlsson system, 32 patients got an A degree and 10 patients got a B degree at three months post-operatively; 26 patients got an A degree and 16 patients got a B degree at the latest follow-up; 6 patients got an A degree at 3 months after operation lowered to B degree at the latest follow-up. The coracoid-clavicle distance increased from (26.91 +/- 0.91) mm at 3 months after operation to (27.41 +/- 1.10) mm at the latest follow-up. Te patients treated with over-reduction during operation or with heavy physical labour work after operation had obvious widened coracoid-clavicle distance. Bone absorption was found around the plate in most cases, mainly in the clavicular side.

CONCLUSION

Treatment for acromioclavicular joint dislocations of Tossy type III with modified double Endobutton technique has satisfactory early clinical results. But with time passing, loss of reduction and bone absorption around the plate could be observed, and clinical outcomes of some cases downgrade during the long-term follow-up.

摘要

目的

探讨改良双Endobutton技术治疗TossyⅢ型肩锁关节脱位的长期临床疗效。

方法

回顾性分析2008年12月至2010年12月采用改良双Endobutton技术治疗的42例TossyⅢ型肩锁关节脱位患者的临床资料。其中男24例，女18例，年龄21～56岁，平均32.5岁。所有患者均行切开复位，采用双Endobutton技术重建喙锁韧带，并修复肩锁韧带。采用Karlsson评分系统评价疗效，测量喙突至锁骨的距离评估复位丢失情况。

结果

所有患者均获随访，随访时间2.0～3.2年，平均2.4年。术后3个月按Karlsson评分系统评定：A组32例，B组10例；末次随访时A组26例，B组16例；术后3个月为A组，末次随访降为B组者6例。喙锁距离由术后3个月的(26.91±0.91)mm增加至末次随访时的(27.41±1.10)mm。术中过度复位或术后从事重体力劳动者，喙锁距离明显增宽。多数病例钢板周围出现骨吸收，以锁骨侧为主。