Department of Shoulder and Elbow Surgery, Celio Military Hospital, Rome, Italy.
Department of Anatomy, Histology, Legal Medicine and Orthopedics, Sapienza University of Rome-Polo Pontino (ICOT), Latina, Italy.
Knee Surg Sports Traumatol Arthrosc. 2021 Jul;29(7):2055-2063. doi: 10.1007/s00167-020-06013-5. Epub 2020 Apr 25.
Although many open techniques have been developed, no all-arthroscopic technique has been introduced to reduce acute acromioclavicular joint dislocation (ACJD) and augment both coracoclavicular (CC) ligaments. The Kite technique is the first all arthroscopic technique with this aim.
Forty-one consecutive patients [35M-6F; median: 29.2 years (range 23-36)] with acute type III and V acromioclavicular joint dislocation were treated with the Kite technique: it consists of positioning three titanium buttons connected by heavy sutures in an 8-strand configuration between clavicle and coracoid to restore the anatomy of CC ligaments. Patients were followed up for a median of 35 months (range 30-43 months).
Median operation time was 70.6 min (range 58-82), with no cases of intra-operative complications. At the final follow-up, the median post-operative Constant Score and SST were 94.1 (range 89-98) and 11.6 (range 10-12), respectively. At the final follow-up reduction maintenance was present in 39 patients; in one patient, signs of acromioclavicular joint dislocation recurrence were present 3 months post-op. In another patient, medial suture ruptures occurred 4 months after surgery with type II acromioclavicular joint dislocation recurrence but with scarce symptoms and full recovery to sport activity. Clavicle osteolysis was observed in four patients. Cosmetics of the arm were judged as excellent in 39/41. All patients, except two, were satisfied with the final result.
The kite technique is a safe and reproducible arthroscopic procedure to treat acute ACJD. In daily clinical practice, due to the excellent results and the low complication rate, this technique might be considered by surgeons when operative treatment of an acute acromioclavicular joint dislocation is planned.
IV.
尽管已经开发出许多开放式技术，但尚无任何全关节镜技术可用于减少急性肩锁关节脱位（ACJD）并增强喙锁（CC）韧带。风筝技术是第一个具有此目的的全关节镜技术。
对 41 例连续的急性 III 型和 V 型肩锁关节脱位患者采用风筝技术进行治疗：该技术包括在锁骨和喙突之间以 8 股缝线将 3 个钛制纽扣定位成一条线，以重建 CC 韧带的解剖结构。患者平均随访 35 个月（范围 30-43 个月）。
中位手术时间为 70.6 分钟（范围 58-82 分钟），无术中并发症。末次随访时，中位术后Constant 评分和 SST 分别为 94.1（范围 89-98）和 11.6（范围 10-12）。末次随访时，39 例患者维持复位；1 例患者术后 3 个月出现肩锁关节脱位复发迹象；另 1 例患者术后 4 个月出现内侧缝线断裂，发生 II 型肩锁关节脱位复发，但症状轻微，可完全恢复运动活动。4 例患者出现锁骨溶解。41 例患者中有 39 例手臂外观被评为优秀。除 2 例外，所有患者均对最终结果满意。
风筝技术是一种安全且可重复的关节镜手术，可用于治疗急性 ACJD。在日常临床实践中，由于手术效果好且并发症发生率低，因此当计划对急性肩锁关节脱位进行手术治疗时，外科医生可能会考虑采用该技术。
IV。
