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采用胸锁关节专用钢板治疗创伤性胸锁关节脱位的长期疗效

Long-term results for traumatic sternoclavicular joint dislocation treated with a sternoclavicular joint-specific plate.

作者信息

Wang Shouli, Chen Zhongyi, Lin Lie, Pan Qiaohong, Wang Bin, Liu Fucun, Zhang Chuanyi

机构信息

Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Linhai, China.

Department of Orthopedics, Changzheng Hospital of Shanghai, Shanghai, China.

出版信息

ANZ J Surg. 2021 Apr;91(4):653-657. doi: 10.1111/ans.16545. Epub 2021 Feb 1.

Abstract

BACKGROUND

The treatment of traumatic sternoclavicular joint (SCJ) dislocation (SCJD) with internal fixation has been reported with good short-term results, but data on its long-term results are scarce.

METHODS

Patients with traumatic SCJD treated with an SCJ-specific plate between January 2003 and January 2018 were evaluated retrospectively. All implants were routinely removed. Data from radiography, the American Shoulder and Elbow Surgeons score, the visual analogue scale and abduction and forward elevation of the shoulder were collected and evaluated before the index surgery, at implant removal and at the latest follow-up.

RESULTS

A total of 22 patients were included in this study with a mean follow-up period of 94.8 months. All patients maintained good reduction after the index surgery and implant removal. The visual analogue scale significantly improved from 7.1 ± 1.3 before the index surgery to 0.9 ± 1.0 at implant removal (P < 0.001) and to 1.0 ± 1.1 at the latest follow-up (P < 0.001); the American Shoulder and Elbow Surgeons score significantly improved from 37.9 ± 10.1 to 90.8 ± 7.8 (P < 0.001) and to 86.7 ± 8.6; and both abduction and forward elevation of the shoulder significantly improved at the latest follow-up (P < 0.001). There was no significant difference in the clinical results after implant removal.

CONCLUSION

Traumatic SCJD treated with an SCJ-specific plate appeared to be efficient, with satisfactory clinical and radiological results at long-term follow-up.

摘要

背景

已有报道称,采用内固定治疗创伤性胸锁关节(SCJ)脱位(SCJD)具有良好的短期效果,但关于其长期效果的数据却很稀少。

方法

对2003年1月至2018年1月期间采用胸锁关节专用钢板治疗创伤性SCJD的患者进行回顾性评估。所有植入物均常规取出。收集并评估了术前、取出植入物时及末次随访时的X线片数据、美国肩肘外科医师评分、视觉模拟评分以及肩部外展和前屈角度。

结果

本研究共纳入22例患者,平均随访时间为94.8个月。所有患者在初次手术后及取出植入物后均维持良好的复位状态。视觉模拟评分从初次手术前的7.1±1.3显著改善至取出植入物时的0.9±1.0(P<0.001),并在末次随访时改善至1.0±1.1(P<0.001);美国肩肘外科医师评分从37.9±10.1显著提高至90.8±7.8(P<0.001),并在末次随访时提高至86.7±8.6;肩部外展和前屈在末次随访时均显著改善(P<0.001)。取出植入物后的临床结果无显著差异。

结论

采用胸锁关节专用钢板治疗创伤性SCJD似乎是有效的,长期随访时临床和影像学结果均令人满意。

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