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前瞻性研究采用自体腓骨长肌腱重建喙锁韧带治疗肩锁关节脱位。

A prospective study of coracoclavicular ligament reconstruction with autogenous peroneus longus tendon for acromioclavicular joint dislocations.

机构信息

Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

出版信息

J Shoulder Elbow Surg. 2018 Jun;27(6):e178-e188. doi: 10.1016/j.jse.2017.12.009. Epub 2018 Feb 1.

Abstract

BACKGROUND

Anatomic coracoclavicular (CC) ligament reconstruction (ACCR) provides good outcomes for Rockwood type III and VI acromioclavicular (AC) joint dislocations. Various grafts have been used, but complications from graft harvesting are not uncommon. This study examined the clinical and radiographic outcomes of patients with AC joint dislocations repaired with the autogenous anterior half of the peroneus longus tendon (AHPLT) to achieve ACCR.

METHODS

Patients with a Rockwood type III to V AC joint dislocation and magnetic resonance imaging of the disruption of the CC ligaments, as well as the AC capsule, were prospectively recruited. Patients received ACCR using an autogenous AHPLT graft and were evaluated clinically and radiographically preoperatively and at 1, 3, 6, and 12 months postoperatively.

RESULTS

A total of 18 patients (mean age, 51 years) were prospectively recruited and received an autogenous AHPLT graft ACCR. Fifteen patients completed clinical and radiographic follow-up examinations at 12 months. The mean Constant score (CS) was 51 preoperatively and 93 at 12 months (P <.005). No significant difference was noted at 12 months between the CS of the injured and contralateral shoulder. The mean American Orthopedic Foot and Ankle Society score at 12 months was 99, and this was not different from the value at any other time point. Loss of reduction occurred in 10 patients (56%), and tunnel widening was observed in 9 (50%), but neither was significantly correlated with functional outcome.

CONCLUSION

Autogenous AHPLT appears to be a reliable tendon graft source for CC ligament reconstruction.

摘要

背景

解剖型肩锁关节(CC)韧带重建(ACCR)可为 Rockwood Ⅲ型和Ⅵ型肩锁关节(AC)脱位患者提供良好的结果。已经使用了各种移植物,但移植物采集的并发症并不少见。本研究检查了使用自体腓骨长肌腱前半部分(AHPLT)进行 AC 关节脱位修复以实现 ACCR 的患者的临床和影像学结果。

方法

前瞻性招募了 Rockwood Ⅲ至Ⅴ型 AC 关节脱位且磁共振成像显示 CC 韧带和 AC 囊破裂的患者。患者接受了自体 AHPLT 移植物的 ACCR,并在术前和术后 1、3、6 和 12 个月进行了临床和影像学评估。

结果

共前瞻性招募了 18 例患者(平均年龄 51 岁),并接受了自体 AHPLT 移植物的 ACCR。15 例患者在 12 个月时完成了临床和影像学随访检查。术前平均 Constant 评分(CS)为 51,术后 12 个月为 93(P<.005)。12 个月时,患侧和对侧肩部 CS 之间无显著差异。12 个月时,美国骨科足踝协会评分的平均值为 99,与其他任何时间点均无差异。10 例患者(56%)发生复位丢失,9 例患者(50%)发生隧道增宽,但均与功能结果无显著相关性。

结论

自体 AHPLT 似乎是 CC 韧带重建的可靠肌腱移植物来源。

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