Faggiani M, Vasario G P, Mattei L, Calò M J, Castoldi F
Department of Orthopaedics and Traumatology, CTO and Maria Adelaide Hospital, University of Turin Medical School, 29, Via Zuretti, 10126, Turin, TO, Italy.
Musculoskelet Surg. 2016 Dec;100(3):187-191. doi: 10.1007/s12306-016-0411-6. Epub 2016 Jun 10.
Acromioclavicular joint (ACJ) dislocation is a common injury that can result from sports activities. The surgical technique for the treatment of Type III and Type IV injuries, according to the Rockwood classification, remains controversial. The purpose of the study was to determine the functional outcome after minimally invasive and arthroscopic surgery. The mini-open surgery was done with MINAR system, whereas the arthroscopic technique was done with Dog Bone Button.
Retrospective Cohort study.
We reviewed 31 who were surgically treated for acute acromioclavicular dislocation Type III and Type IV (2012-2015). We excluded subjects with chronic dislocation or other injury. We selected 16 patients (average age 37). Half of the sample patients were treated with mini-open surgery with the MINAR system, and the other half of the patients were treated with the Dog Bone arthroscopic technique. The Constant Shoulder Score, the Oxford Shoulder Score, the Simple Shoulder Test and the Subjective Patient Outcome for Return to Sports (SPORTS) score were used to assess functional outcome of the treated shoulder.
Mean follow-up was 13 months (range 6-27 months). The mean Constant Shoulder Score was 91.10 (range 82.76-96.66), Oxford Shoulder Score was 46.19 (range 42.00-48.00), the Simple Shoulder Test was 10.50 (range 9.00-12.00), and the SPORTS score was 7.88 (range 3-10). There is a statistically significant difference between the sample operated with the mini-open surgery and the group operated with arthroscopic technique. The probability of return to their sport, according to the results of the SPORTS score, was significantly higher for patients treated with the MINAR system (p < 0.001). However, the objective parameter of Constant scale is statistically better in patients operated by arthroscopic technique (p < 0.05; p < 0.001).
Restoration of ACJ anatomy is the key to a successful therapy. The surgical technique should be personalized. The miny-open surgery and also the arthroscopic surgery are adequate with good clinical results. However, according to the SPORTS score, the patients treated with mini-open surgery returned to their sport with less pain and better performance than those belonging to the other group.
肩锁关节（ACJ）脱位是一种常见的损伤，可由体育活动导致。根据Rockwood分类法，治疗III型和IV型损伤的手术技术仍存在争议。本研究的目的是确定微创和关节镜手术后的功能结果。迷你开放手术使用MINAR系统进行，而关节镜技术使用Dog Bone Button进行。
回顾性队列研究。
我们回顾了31例接受手术治疗的急性III型和IV型肩锁关节脱位患者（2012 - 2015年）。我们排除了慢性脱位或其他损伤的患者。我们选择了16例患者（平均年龄37岁）。样本患者中有一半接受了使用MINAR系统的迷你开放手术，另一半患者接受了Dog Bone关节镜技术治疗。使用Constant肩关节评分、牛津肩关节评分、简单肩关节测试和主观患者运动恢复结果（SPORTS）评分来评估治疗后肩部的功能结果。
平均随访时间为13个月（范围6 - 27个月）。Constant肩关节平均评分为91.10（范围82.76 - 96.66），牛津肩关节评分为46.19（范围42.00 - 48.00），简单肩关节测试评分为10.50（范围9.00 - 12.00），SPORTS评分为7.88（范围3 - 10）。接受迷你开放手术的样本组与接受关节镜技术手术的组之间存在统计学上的显著差异。根据SPORTS评分结果，使用MINAR系统治疗的患者恢复运动的概率显著更高（p < 0.001）。然而，Constant量表的客观参数在接受关节镜技术手术的患者中在统计学上更好（p < 0.05；p < 0.001）。
恢复肩锁关节解剖结构是成功治疗的关键。手术技术应个性化。迷你开放手术和关节镜手术都足够且临床效果良好。然而，根据SPORTS评分，接受迷你开放手术治疗的患者比另一组患者恢复运动时疼痛更少且表现更好。
