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[自体与异体肌腱移植联合钩钢板固定重建喙锁韧带治疗肩锁关节脱位的疗效比较]

[EFFECTIVENESS COMPARISON OF CORACOCLAVICULAR LIGAMENT RECONSTRUCTION BETWEEN BY AUTOLOGOUS AND ALLOGENEIC TENDON GRAFTS COMBINED WITH HOOK PLATE FIXATION FOR TREATING ACROMIOCLAVICULAR JOINT DISLOCATION].

作者信息

Yin Fei, Sun Zhenzhong, Wei Xuming, Liu Xueguang, Zhou Ming, Zhuang Yin, Song Sheng

机构信息

Department of Orthopedics, Wuxi No. 9 People's Hospital, Suzhou University, Wuxi Jiangsu, 214000, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 May 8;30(5):532-536. doi: 10.7507/1002-1892.20160107.

Abstract

OBJECTIVE

To compare the effectiveness of coracoclavicular ligament reconstruction between by using autologous plantaris tendon graft combined with hook plate fixation and allogeneic tendon graft combined with hook plate fixation for treating acromiocavicular joint dislocation.

METHODS

Thirty-three patients with acromioclavicular joint dislocation who accorded with the inclusion criteria between January 2013 and June 2014 were assigned into 2 groups. The patients were treated with autologous plantaris tendon graft combined with hook plate fixation in group A (=17), and with allogeneic tendon graft combined with hook plate fixation in group B (=16). Thirteen-one patients was followed up more than 12 months (15 in group A and 16 in group B). There was no significant difference in gender, age, cause of injury, sides, time between injury and surgery, and type of dislocation (>0.05). The assessments included operation time, hospitalization time, hospitalization expenses, shoulder range of motion, gap of acromioclavicular, Constant-Murley scores, and visual analogue scale (VAS) for pain.

RESULTS

The operation time of group A was significantly longer than that of group B, and the hospitalization expense was significantly lower than that of group B (<0.05). There was no significant difference in hospitalization time (=1.046, =0.316). The incisions healed by first intention, and hook plate was removed after 3 months. The mean follow-up time was 21.3 months (range, 19-34 months) in group A and was 23.7 months (range, 18-37 months) in group B. X-ray examination showed no osteolysis. There was no significant difference in gap of acromiocavicular between 2 groups at preoperation, 1 week after operation, and last follow-up (>0.05). No redislocation of acromioclavicular joint and rejection reaction occurred during follow-up. At last follow-up, there was no significant difference in shoulder range of motion, Constant-Murley score, and VAS score between 2 groups (>0.05).

CONCLUSIONS

Coracoclavicular ligament reconstruction by autologous plantaris tendon or allogeneic tendon graft combined with hook plate fixation for the treatment of acromioclavicular joint dislocation can achieve good effectiveness. The appropriate treatment should be chosen according to the patient's economic situation.

摘要

目的

比较自体跖肌腱移植联合钩钢板固定与异体肌腱移植联合钩钢板固定重建喙锁韧带治疗肩锁关节脱位的疗效。

方法

选取2013年1月至2014年6月符合纳入标准的33例肩锁关节脱位患者,分为2组。A组(n = 17)采用自体跖肌腱移植联合钩钢板固定治疗,B组(n = 16)采用异体肌腱移植联合钩钢板固定治疗。31例患者获得12个月以上随访(A组15例,B组16例)。两组患者在性别、年龄、损伤原因、患侧、受伤至手术时间及脱位类型等方面比较,差异均无统计学意义(P > 0.05)。观察指标包括手术时间、住院时间、住院费用、肩关节活动度、肩锁关节间隙、Constant - Murley评分及视觉模拟评分法(VAS)疼痛评分。

结果

A组手术时间显著长于B组,住院费用显著低于B组(P < 0.05)。两组住院时间比较,差异无统计学意义(t = 1.046,P = 0.316)。切口均一期愈合,术后3个月取出钩钢板。A组平均随访时间为21.3个月(19~34个月),B组为23.7个月(18~37个月)。X线检查未见骨质溶解。两组术前、术后1周及末次随访时肩锁关节间隙比较,差异均无统计学意义(P > 0.05)。随访期间未发生肩锁关节再脱位及排斥反应。末次随访时,两组肩关节活动度、Constant - Murley评分及VAS评分比较,差异均无统计学意义(P > 0.05)。

结论

自体跖肌腱或异体肌腱移植联合钩钢板固定重建喙锁韧带治疗肩锁关节脱位均可取得良好疗效,应根据患者经济情况选择合适的治疗方法。

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