缝线锚钉与钩钢板重建喙锁韧带治疗锁骨远端骨折的临床疗效比较
Clinical efficacies of coracoclavicular ligament reconstruction using suture anchor versus hook plate in the treatment of distal clavicle fracture.
作者信息
Yan H W, Li L, Wang R C, Yang Y, Xie Y, Tang J, Shi Z Y
机构信息
The Fourth Affiliated Hospital of Guangxi Medical University, Liu Zhou Worker's Hospital, Liuzhou, Guangxi 545005, China.
The Fourth Affiliated Hospital of Guangxi Medical University, Liu Zhou Worker's Hospital, Liuzhou, Guangxi 545005, China.
出版信息
Orthop Traumatol Surg Res. 2017 Dec;103(8):1287-1293. doi: 10.1016/j.otsr.2017.07.006. Epub 2017 Aug 8.
INTRODUCTION
Comparison of clinical efficacies between coracoclavicular ligament reconstruction using autologous gracilis tendon with suture anchor and clavicular hook plate for the treatment of acute Neer type II distal clavicle fracture.
HYPOTHESIS
Both coracoclavicular reconstruction with autologous gracilis tendon and clavicular hook plate could achieve satisfactory results for treating acute Neer type II distal clavicle fracture.
METHODS
Acute Neer type II distal clavicle fracture patients enrolled in this prospective randomized study were divided into the coracoclavicular ligament reconstruction group (using autologous gracilis tendon and suture anchor) and the hook plate group. Clinical outcomes were evaluated by shoulder X-ray, forward flexion, abduction and external rotation angle, Constant-Murley shoulder score and pain Visual Analogue Scale (VAS) at each follow-up for up to 24 months.
RESULTS
The current study enrolled a total of 42 acute Neer type II distal clavicle fracture patients attended our hospital from March 2010 to December 2013. All patients had achieved complete healing and followed up for an average of 26 months (range, 24-38 months). At 3-month and 6-month follow-ups, Constant-Murley score in the ligament reconstruction group was significantly higher (93.8±2.6 vs. 88.7±8.7; 95.9±2.7 vs. 93.0±7.0, P<0.05), while VAS score was poorer than those in the hook plate group (1.6±0.8 vs. 2.5±1.9; 1.1±1.0 vs. 1.6±1.7, P<0.05).
DISCUSSION
Reconstruction with autologous gracilis tendon improved VAS pain score in early postoperation follow-up; while Constant-Murley score and VAS score were significantly improved in the hook plate group after the implant was removed. These suggested that both coracoclavicular reconstruction with autologous gracilis tendon and clavicular hook plate could achieve satisfactory results.
LEVEL OF EVIDENCE
Level II, low-powered prospective randomized trial.
引言
比较自体股薄肌腱联合缝线锚钉重建喙锁韧带与锁骨钩钢板治疗急性Neer II型锁骨远端骨折的临床疗效。
假设
自体股薄肌腱重建喙锁韧带与锁骨钩钢板治疗急性Neer II型锁骨远端骨折均可取得满意疗效。
方法
本前瞻性随机研究纳入的急性Neer II型锁骨远端骨折患者被分为喙锁韧带重建组（采用自体股薄肌腱和缝线锚钉）和钩钢板组。在长达24个月的每次随访中，通过肩部X线、前屈、外展和外旋角度、Constant-Murley肩关节评分以及疼痛视觉模拟量表（VAS）评估临床疗效。
结果
本研究共纳入2010年3月至2013年12月在我院就诊的42例急性Neer II型锁骨远端骨折患者。所有患者均实现完全愈合，平均随访26个月（范围24 - 38个月）。在3个月和6个月随访时，韧带重建组的Constant-Murley评分显著更高（93.8±2.6对88.7±8.7；95.9±2.7对93.0±7.0，P<0.05），而VAS评分低于钩钢板组（1.6±0.8对2.5±1.9；1.1±1.0对1.6±1.7，P<0.05）。
讨论
自体股薄肌腱重建在术后早期随访中改善了VAS疼痛评分；而在取出植入物后，钩钢板组的Constant-Murley评分和VAS评分显著改善。这表明自体股薄肌腱重建喙锁韧带与锁骨钩钢板均可取得满意疗效。
证据级别
II级，低效能前瞻性随机试验。
Zotero 插件