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卡德纳尔手术治疗肩锁关节脱位的临床疗效

Clinical outcomes of the Cadenat procedure in the treatment of acromioclavicular joint dislocations.

作者信息

Moriyama Hiroaki, Gotoh Masafumi, Mitsui Yasuhiro, Yoshikawa Eiichirou, Uryu Takuya, Okawa Takahiro, Higuchi Fujio, Shirahama Masahiro, Shiba Naoto

机构信息

Department of Orthopedic Surgery, Kurume University Medical Center.

出版信息

Kurume Med J. 2014;61(1-2):17-21. doi: 10.2739/kurumemedj.MS64001. Epub 2014 Aug 25.

Abstract

We report our clinical experience using the modified Cadenat method to treat acromioclavicular joint dislocation, and discuss the usefulness of this method. This study examined 6 shoulders in 6 patients (5 males, 1 female) who were diagnosed with acromioclavicular joint dislocation and treated with the modified Cadenat method at our hospital. Average age at onset was 49.3 years (26-78 years), average time interval from injury until surgery was 263.8 days (10 to 1100 days), and the average follow-up period was 21.7 months (12 to 42 months). Post-operative assessment was performed using plain radiographs to determine shoulder joint dislocation rate and Japanese Orthopaedic Association (JOA) score. The average post-operative JOA score was 94.1 points (91 to 100 points). The acromioclavicular joint dislocation rate improved from 148.7% (72 to 236%) before surgery to 28.6% (0 to 60%) after surgery. Conservative treatment has been reported to achieve good outcomes in acromioclavicular joint dislocations. However, many patients also experience chronic pain or a sensation of fatigue upon putting the extremity in an elevated posture, and therefore ensuring the stability of the acromioclavicular joint is crucial for highly active patients. In this study, we treated acromioclavicular joint dislocations by the modified Cadenat method, and were able to achieve favorable outcomes.

摘要

我们报告了使用改良的卡德那特(Cadenat)方法治疗肩锁关节脱位的临床经验,并讨论了该方法的实用性。本研究对我院6例诊断为肩锁关节脱位并采用改良卡德那特方法治疗的患者(5例男性,1例女性)的6个肩部进行了检查。发病时的平均年龄为49.3岁(26 - 78岁),受伤至手术的平均时间间隔为263.8天(10至1100天),平均随访期为21.7个月(12至42个月)。术后通过X线平片进行评估,以确定肩关节脱位率和日本骨科协会(JOA)评分。术后JOA评分平均为94.1分(91至100分)。肩锁关节脱位率从术前的148.7%(72至236%)改善至术后的28.6%(0至60%)。据报道,保守治疗在肩锁关节脱位中可取得良好效果。然而,许多患者在将肢体抬高时也会经历慢性疼痛或疲劳感,因此对于活动度高的患者而言,确保肩锁关节的稳定性至关重要。在本研究中,我们采用改良的卡德那特方法治疗肩锁关节脱位,并取得了良好的效果。

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