Department of Hand Surgery, Affiliated Hospital of Nantong University, 20# West Temple Road, Nantong, 226001, People's Republic of China.
Department of Hand Surgery, Shanghai General Hospital, 650# Songjiang Road, Shanghai, 201620, People's Republic of China.
J Orthop Surg Res. 2018 Jul 11;13(1):175. doi: 10.1186/s13018-018-0879-x.
The purpose of this study was to compare outcomes between allograft reconstruction and hook plate fixation for acute dislocation of the acromioclavicular joint with a minimum 2-year follow-up.
A retrospective comparative study of patients treated for acute acromioclavicular joint dislocation from February 2010 to December 2014 in our hospital, consisting of 16 patients who were followed-up, was performed. Eight patients were treated for acute AC dislocation and underwent surgical reconstruction as follows: the coracoclavicular and acromioclavicular ligaments were reconstructed with the allogenic tendon. The other eight patients were treated with hook plates to maintain the AC joint reset. At the latest follow-up, radiographic analysis and the Constant and University of California-Los Angeles (UCLA) scores were used to evaluate shoulder function. The satisfaction of the patients in terms of the efficacy and visual analog scale (VAS) data were also recorded.
After an average follow-up of 30.3 months (range 24-46 months), no patient had dislocated their joint again at the final follow-up based on X-ray examination. The Constant score was 94.4 for the allogenic tendon group and 93.8 for the hook plate group (P = 0.57). According to the UCLA scale (P = 0.23) or VAS (P = 0.16), we found no significant difference between the two groups. All patients reported that they were very satisfied or satisfied with the outcome of surgery, and no significant difference (P = 0.08) was found between the two groups.
The use of allogenic tendon for reconstruction of the coracoclavicular and acromioclavicular ligaments shows excellent outcomes in terms of the recovery of clinical function or radiographic outcomes for acute AC dislocation. Compared with the hook plate, the hardware did not need to be removed.
本研究旨在比较同种异体肌腱重建与钩板固定治疗急性肩锁关节脱位的疗效，随访时间至少 2 年。
对 2010 年 2 月至 2014 年 12 月在我院治疗的急性肩锁关节脱位患者进行回顾性对比研究，共随访 16 例患者。8 例患者急性 AC 脱位采用手术重建治疗，具体方法为：同种异体肌腱重建喙锁和肩锁韧带。另 8 例患者采用钩板固定维持 AC 关节复位。末次随访时，采用放射学分析和 Constant 和加利福尼亚大学洛杉矶分校（UCLA）评分评估肩部功能。还记录了患者对疗效和视觉模拟量表（VAS）数据的满意度。
平均随访 30.3 个月（范围 24-46 个月）后，根据 X 线检查，所有患者最终随访时均未再次出现关节脱位。同种异体肌腱组的 Constant 评分为 94.4 分，钩板组为 93.8 分（P=0.57）。根据 UCLA 评分（P=0.23）或 VAS（P=0.16），两组间无显著差异。所有患者均报告对手术结果非常满意或满意，两组间无显著差异（P=0.08）。
同种异体肌腱重建喙锁和肩锁韧带治疗急性 AC 脱位，在临床功能恢复或放射学结果方面效果显著。与钩板相比，该方法无需取出内固定。
