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应用斜方肌筋膜重建韧带治疗完全性肩锁关节脱位及筋膜化生观察

Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia.

作者信息

Wang Chaoliang, Huang Sufang, Wang Yingzhen, Sun Xuesheng, Zhu Tao, Li Qiang, Lin Chu

机构信息

Medical College of Qingdao University, Qingdao, Shandong, 266003, China Department of Orthopaedic Surgery, Affiliated Laiwu Hospital of Taishan Medical College, Laiwu, Shandong 271100, China.

Department of Orthopaedic Surgery, Affiliated Laiwu Hospital of Taishan Medical College, Laiwu, Shandong 271100, China.

出版信息

Open Med (Wars). 2015 Dec 17;10(1):370-376. doi: 10.1515/med-2015-0055. eCollection 2015.

Abstract

We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated by reconstruction of the acromioclavicular and coracoclavicular ligament using trapezius muscle fascia. Open reduction and internal fixation was performed using the clavicular hook plate in 12 patients with acute complete acromioclavicular joint dislocation, and the acromioclavicular and coracoclavicular ligaments were reconstructed using trapezius muscle fascia. Radiographic evaluations were conducted postoperatively. We evaluated the functional results with constant scoring system and radiological results at the final follow-up visit. The mean Constant score at the final follow-up visit was 91.67 (range, 81 to 100). The results were excellent in eight patients (66.7%) and good in four patients (33.3%). Three patients with scores from 80 to 90 had mild pain during activity, but this did not affect the range of motion of the shoulder. All patients have returned to their preoperative work without any limitations. Compared with the contralateral side, radiography showed anatomical reposition in the vertical plane in all cases. The hook-plate fixation with ligament reconstruction was successful in treating AC dislocations. The acromioclavicular and coracoclavicular ligament were reconstructed by trapezius muscle fascia that keep the distal clavicle stable both vertically and horizontally after type III injuries.

摘要

我们评估了采用斜方肌筋膜重建肩锁韧带和喙锁韧带治疗急性完全性肩锁关节脱位的长期临床效果。对12例急性完全性肩锁关节脱位患者采用锁骨钩钢板进行切开复位内固定,并采用斜方肌筋膜重建肩锁韧带和喙锁韧带。术后进行影像学评估。我们在末次随访时采用Constant评分系统评估功能结果,并评估影像学结果。末次随访时的平均Constant评分为91.67(范围81至100)。8例患者(66.7%)结果为优,4例患者(33.3%)结果为良。3例评分在80至90分的患者在活动时有轻度疼痛,但这并未影响肩关节的活动范围。所有患者均已恢复术前工作,无任何限制。与对侧相比,影像学检查显示所有病例在垂直平面均实现解剖复位。采用韧带重建的钩钢板固定成功治疗了肩锁关节脱位。Ⅲ型损伤后,采用斜方肌筋膜重建肩锁韧带和喙锁韧带可使锁骨远端在垂直和水平方向均保持稳定。

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