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同种异体移植改良“8”字法重建胸锁关节的疗效

Outcomes of augmented allograft figure-of-eight sternoclavicular joint reconstruction.

作者信息

Sabatini Jefferson B, Shung Joseph R, Clay T Bradly, Oladeji Lasun O, Minnich Douglas J, Ponce Brent A

机构信息

Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.

Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA.

出版信息

J Shoulder Elbow Surg. 2015 Jun;24(6):902-7. doi: 10.1016/j.jse.2014.10.001. Epub 2014 Dec 3.

Abstract

BACKGROUND

Sternoclavicular joint (SCJ) instability is a rare condition resulting in impaired function and shoulder girdle pain. Various methods for stabilizing the SCJ have been proposed, with biomechanical analysis demonstrating superior stiffness and peak load properties with a figure-of-8 tendon graft technique. The purpose of this study was to evaluate the clinical outcomes of SCJ reconstruction with an interference screw figure-of-8 allograft tendon technique.

METHODS

A retrospective analysis of a consecutive cohort of patients from 2007 to 2011 was performed for all patients undergoing SCJ reconstruction for instability. All patients were treated for SCJ instability with a figure-of-8 allograft reconstruction augmented by 2 tenodesis screws. Outcomes were performed with the American Shoulder and Elbow Surgeons (ASES) score, the shortened Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and the visual analog scale (VAS) for pain score for all patients. Intraoperative and postoperative complications were recorded.

RESULTS

A total of 10 patients were included in the study, with an average follow-up of 38 months (range, 11.6-66.8 months). Preoperatively, the mean ASES score was 35.3 points (range, 21.7-55 points), whereas the postoperative mean ASES score increased to 84.7 points (range, 66.6-95 points). The mean VAS score improved from 7.0 (range, 5-10) before surgery to 1.15 (range, 0-3) at follow-up, and the QuickDASH score average was 17.0 points (range, 0 to 38.6 points). Minor postoperative complications were noted in 2 patients.

CONCLUSION

Patients who underwent repair of SCJ instability by an augmented figure-of-8 allograft tendon reconstruction report marked improvements in both shoulder function and pain relief.

摘要

背景

胸锁关节(SCJ)不稳定是一种罕见病症,会导致功能受损和肩带疼痛。已提出多种稳定胸锁关节的方法,生物力学分析表明8字肌腱移植技术具有更高的刚度和峰值负荷特性。本研究的目的是评估采用带袢钢板8字同种异体肌腱技术进行胸锁关节重建的临床效果。

方法

对2007年至2011年间连续队列中因不稳定而接受胸锁关节重建的所有患者进行回顾性分析。所有患者均采用带袢钢板8字同种异体肌腱重建术治疗胸锁关节不稳定。采用美国肩肘外科医师学会(ASES)评分、简化版上肢、肩部和手部功能障碍评分(QuickDASH)以及视觉模拟量表(VAS)疼痛评分对所有患者进行评估。记录术中及术后并发症。

结果

本研究共纳入10例患者,平均随访38个月(范围11.6 - 66.8个月)。术前,ASES评分平均为35.3分(范围21.7 - 55分),而术后平均ASES评分增至84.7分(范围66.6 - 95分)。VAS评分平均从术前的7.0(范围5 - 10)改善至随访时的1.15(范围0 - 3),QuickDASH评分平均为17.0分(范围0至38.6分)。2例患者出现轻微术后并发症。

结论

采用带袢钢板8字同种异体肌腱重建术修复胸锁关节不稳定的患者,其肩部功能和疼痛缓解均有显著改善。

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