Fahmy Fahmy Samir, Fathi Hossam, ElAttar Mohammad
Department of Orthopedic Surgery, Zagazig University, Egypt.
J Orthop. 2019 Feb 27;16(2):133-136. doi: 10.1016/j.jor.2019.02.005. eCollection 2019 Mar-Apr.
Management of high grade acute acromioclavicular (AC) joint dislocation is considered a surgical dilemma. Open methods of fixation are the gold standard but the morbidities are frequent. The goal of this study was to evaluate the results of arthroscopic fixation of acute high grade (AC) joint dislocation.
A series of 24 patients with acute high grade acromioclavicular joint dislocation were fixed arthroscopically using TightRope device. The study was done between February 2013 and February 2017. The functional outcomes were assessed using Constant-Murley score and University of California at Los Angeles shoulder (UCLA) scale. The preoperative and postoperative means of coraco-clavicular distance were calculated and used for radiological assessment. P-value < o.o5 was statistically significant.
The mean followed up time was 23.25 ± 7.1 (12-35) months. There was highly significant improvement in the Constant-Murley score and (UCLA) scale at the end of the follow up period. The coraco-clavicular distance was improved from 21.7 ± 3.1 mm preoperative to 10.17 ± 2.3 mm postoperative. There were two complications, one case had over correction and the other had mild transient post-operative burning pain along the course of ulnar nerve.
Arthroscopic fixation of acute high grade (AC) joint dislocation is safe, minimally invasive technique with satisfactory functional outcomes and low morbidities provided that it is done by surgeons skilled in shoulder arthroscopy.
高级别急性肩锁关节脱位的治疗被认为是一个外科难题。开放固定方法是金标准，但并发症频发。本研究的目的是评估急性高级别肩锁关节脱位的关节镜下固定效果。
采用TightRope装置对24例急性高级别肩锁关节脱位患者进行关节镜下固定。研究于2013年2月至2017年2月进行。使用Constant-Murley评分和加州大学洛杉矶分校肩（UCLA）评分系统评估功能结果。计算术前和术后喙锁距离的平均值并用于影像学评估。P值<0.05具有统计学意义。
平均随访时间为23.25±7.1（12 - 35）个月。随访期末，Constant-Murley评分和UCLA评分系统有高度显著改善。喙锁距离从术前的21.7±3.1mm改善至术后的10.17±2.3mm。出现了2例并发症，1例矫正过度，另1例术后沿尺神经走行有轻度短暂灼痛。
急性高级别肩锁关节脱位的关节镜下固定是一种安全、微创的技术，功能结果满意且并发症少，前提是由熟练掌握肩关节镜技术的外科医生进行操作。
