Chen Kai, Xu Bin, Lao Yang-Jun, Yang Yang
Department of Orthopaedics, Tongde Hospital of Zhejiang, Hangzhou, China.
Ann Transl Med. 2021 Feb;9(4):345. doi: 10.21037/atm-21-404.
Anatomic ligament reconstruction using the EndobutBon device has been proven an effective technique for the management of acute acromioclavicular (AC) joint dislocation. The aim of this study was to analyze the risk factors causing loss of reduction after AC joint dislocation treated with the EndoButton device for open procedures.
A total of 107 patients who met the inclusion and excluded criteria finally were enrolled. We retrospectively analyzed the clinical tests, imaging data, and postoperative rehabilitation of patients in a stable reduction group and a loss of reduction group.
Among all patients included in the study, the incidence of reduction failure was 14%. Univariate analysis identified that the time between injury to surgery, double or triple EndoButton, coracoid EndoButton position, weight-bearing time of the upper limb, and osteolysis had statistically significant associations with loss of reduction for the AC joint (P=0.022, 0.002, 0.000, 0.000, and 0.000 respectively). By using multivariate logistic regression analysis, we found that coracoid EndoButton position (P=0.002), weight-bearing time of the upper limb (P=0.011), and osteolysis (P=0.036) were the significant independent risk factors related to the loss of reduction after AC joint dislocation treated with the EndoButton device used with open procedures.
In order to reduce the incidence of reduction failure and improve the prognosis of patients, more accurate placement of EndoButton plates in surgery and guidance for patients in completing planned rehabilitation training are needed.
使用EndobutBon装置进行解剖学韧带重建已被证明是治疗急性肩锁关节(AC)脱位的有效技术。本研究的目的是分析在开放性手术中使用EndoButton装置治疗AC关节脱位后导致复位丢失的危险因素。
最终纳入了107例符合纳入和排除标准的患者。我们回顾性分析了稳定复位组和复位丢失组患者的临床检查、影像学数据及术后康复情况。
在本研究纳入的所有患者中,复位失败的发生率为14%。单因素分析确定,受伤至手术的时间、双EndoButton或三EndoButton、喙突EndoButton位置、上肢负重时间和骨质溶解与AC关节复位丢失在统计学上有显著关联(P值分别为0.022、0.002、0.000、0.000和0.000)。通过多因素逻辑回归分析,我们发现喙突EndoButton位置(P=0.002)、上肢负重时间(P=0.011)和骨质溶解(P=0.036)是与开放性手术使用EndoButton装置治疗AC关节脱位后复位丢失相关的显著独立危险因素。
为了降低复位失败的发生率并改善患者的预后,手术中需要更准确地放置EndoButton钢板,并指导患者完成计划的康复训练。