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使用缝线锚钉增强喙锁韧带的改良Phemister手术治疗急性肩锁关节脱位的临床和影像学结果

Clinical and Radiological Outcomes of Modified Phemister Operation with Coracoclavicular Ligament Augmentation Using Suture Anchor for Acute Acromioclavicular Joint Dislocation.

作者信息

Cho Nam Su, Bae Sung Ju, Lee Joong Won, Seo Jeung Hwan, Rhee Yong Girl

机构信息

Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.

出版信息

Clin Shoulder Elb. 2019 Jun 1;22(2):93-99. doi: 10.5397/cise.2019.22.2.93. eCollection 2019 Jun.

Abstract

BACKGROUND

Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation.

METHODS

Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments.

RESULTS

At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was 164.6°, external rotation at the side was 61.2°, and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values.

CONCLUSIONS

The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation.

摘要

背景

改良菲米斯特手术已广泛应用于急性肩锁关节脱位的治疗。此外,据报道使用缝合锚钉进行喙锁固定可提供喙锁稳定性。本研究旨在评估采用缝合锚钉加强喙锁韧带的改良菲米斯特手术治疗急性肩锁关节脱位的临床和影像学结果。

方法

74例急性肩锁关节脱位患者接受了采用缝合锚钉加强喙锁韧带的改良菲米斯特手术,并平均随访12.3个月。采用视觉模拟评分法(VAS)、活动范围、常数评分和韩国肩部评分系统(KSS)进行临床评估。测量肩锁关节间隙(ACI)、喙锁距离(CCD)和肩锁距离(ACD)以进行影像学评估。

结果

末次随访时,平均VAS评分为1.7分,前屈平均关节活动范围为164.6°,侧方外旋为61.2°,向后内旋达T12水平。平均常数评分为82.7分,平均KSS评分为84.2分。在平均ACI、CCD和ACD方面,术前与末次随访时存在显著差异。末次随访时,将患侧的ACI、CCD和ACD与对侧未受影响的肩部进行比较,患侧肩部的值显著更高。

结论

采用缝合锚钉加强喙锁韧带的改良菲米斯特手术在治疗急性肩锁关节脱位方面在临床和影像学上均有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9242/7714295/c0c508ee0947/cise-2019-22-2-93f1.jpg

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