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关节镜辅助下双Endobutton“8”字扣固定治疗Rockwood 型急性肩锁关节脱位的疗效

[Effectiveness of arthroscopic assisted double Endobutton "8" buckle fixation in treatment of Rockwood type acute acromioclavicular joint dislocation].

作者信息

Deng Fuyuan, Li Zhong, Liu Juncai

机构信息

Department of Orthopedics, the Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Sep 15;34(9):1125-1129. doi: 10.7507/1002-1892.202002117.

Abstract

OBJECTIVE

To investigate the short-term effectiveness of arthroscopic assisted double Endobutton "8" buckle fixation in the treatment of Rockwood Ⅲ type acute acromioclavicular joint dislocation.

METHODS

The clinical data of 12 patients with Rockwood Ⅲ type acute acromioclavicular joint dislocation who were treated with arthroscopic assisted double Endobutton "8" buckle fixation between June 2016 and June 2019 were analyzed retrospectively. There were 8 males and 4 females, with an average age of 47.0 years (range, 36-58 years). There were 4 cases of left shoulder and 8 cases of right shoulder. The causes of injury included traffic accident injury in 7 cases and falling injury in 5 cases. The average time from injury to operation was 5.0 days (range, 3-14 days). Before operation and at last follow-up, the shoulder joint activity was recorded; the improvements of function and pain were evaluated by Constant score and visual analogue scale (VAS) score, respectively; the reduction was evaluated by measuring the coracoid spacing of the affected side on the anteroposterior X-ray film of shoulder joint.

RESULTS

All 12 cases were followed up 6-36 months, with an average of 20.6 months. All the incisions healed by first intention. There was no complications such as clavicle and coracoid fractures and Endobuton displacement. At last follow-up, the range of motion of the abduction improved from preoperative (77.5±4.5)° to (162.5±6.5)°, the range of motion of forward flexion improved from (84.1±5.2)° to (169.5±5.8)°, the Constant score improved from 42.5±2.3 to 92.4±2.3, the VAS score improved from 5.4±0.8 to 0.6±0.5, and the coracoid spacing reduced from (20.5±1.4) mm to (9.2±0.6) mm, all showing significant differences ( <0.05).

CONCLUSION

Arthroscopic assisted double Endobutton "8" buckle fixation for the treatment of Rockwood Ⅲ type acute acromioclavicular joint dislocation is safe, less invasive, and quicker recovery. It can effectively alleviate shoulder pain, significantly improve the mobility of the shoulder joint, and achieve good short-term effectiveness.

摘要

目的

探讨关节镜辅助下双Endobutton“8”字扣固定治疗RockwoodⅢ型急性肩锁关节脱位的短期疗效。

方法

回顾性分析2016年6月至2019年6月采用关节镜辅助下双Endobutton“8”字扣固定治疗的12例RockwoodⅢ型急性肩锁关节脱位患者的临床资料。其中男性8例,女性4例,平均年龄47.0岁(范围36 - 58岁)。左肩4例,右肩8例。损伤原因包括交通事故伤7例,坠落伤5例。受伤至手术的平均时间为5.0天(范围3 - 14天)。术前及末次随访时记录肩关节活动度;分别采用Constant评分和视觉模拟评分法(VAS)评估功能及疼痛改善情况;通过测量肩关节前后位X线片上患侧喙突间距评估复位情况。

结果

12例均获随访6 - 36个月,平均20.6个月。所有切口均一期愈合。未出现锁骨及喙突骨折、Endobuton移位等并发症。末次随访时,外展活动度由术前(77.5±4.5)°改善至(162.5±6.5)°,前屈活动度由(84.1±5.2)°改善至(169.5±5.8)°,Constant评分由42.5±2.3提高至92.4±2.3,VAS评分由5.4±0.8降至0.6±0.5,喙突间距由(20.5±1.4)mm缩小至(9.2±0.6)mm,差异均有统计学意义(<0.05)。

结论

关节镜辅助下双Endobutton“8”字扣固定治疗RockwoodⅢ型急性肩锁关节脱位安全、微创、恢复快。能有效缓解肩部疼痛,显著改善肩关节活动度,取得良好的短期疗效。

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[Arthroscopic Twin Tail TightRope combined with distal joint capsule repair technique for acute acromioclavicular dislocation].
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Rockwood Type III Acromioclavicular Joint Dislocation; Are We Still Fighting?
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