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因喙突骨折导致的V型肩锁关节分离失败的治疗:肩锁关节-喙锁关节重建及喙突固定翻修术

Treatment of a Failed Type V Acromioclavicular Separation Due to Coracoid Fracture: Revision of Acromioclavicular-Coracoclavicular Reconstruction and Coracoid Fixation.

作者信息

Goliganin Petar, Waltz Robert, Peebles Annalise M, Provencher Connor, Provencher Matthew T

机构信息

Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire.

Tuck School of Business at Dartmouth College, Hanover, New Hampshire.

出版信息

Arthrosc Tech. 2021 Feb 2;10(3):e675-e681. doi: 10.1016/j.eats.2020.10.055. eCollection 2021 Mar.

Abstract

Acromioclavicular (AC) injuries are common, especially in the young and active population. AC joint dislocations account for 8% of all joint dislocations and are even more common in contact sports. These injuries are graded as type I through type VI on the basis of the Rockwood classification method. Types I and II are generally treated without surgery whereas types IV, V, and VI are best treated operatively. Type III dislocations remain controversial in terms of treatment, and many surgeons recommend nonoperative treatment first and operative treatment in case of continued symptoms such as pain, instability, or shoulder girdle dysfunction. The goal of operative treatment is to restore AC joint stability, which involves addressing both the coracoclavicular and coracoacromial ligaments to achieve a desirable patient outcome. The objective of this Technical Note is to describe our technique for management of a failed acromioclavicular stabilization, treated with a coracoclavicular and AC joint capsular reconstruction using tibialis anterior and semitendinosus allografts.

摘要

肩锁关节(AC)损伤很常见,尤其在年轻活跃人群中。肩锁关节脱位占所有关节脱位的8%,在接触性运动中更为常见。根据Rockwood分类法,这些损伤分为I型至VI型。I型和II型通常无需手术治疗,而IV型、V型和VI型最好采用手术治疗。III型脱位在治疗方面仍存在争议,许多外科医生建议首先采用非手术治疗,若出现持续症状如疼痛、不稳定或肩带功能障碍,则采用手术治疗。手术治疗的目标是恢复肩锁关节稳定性,这涉及处理喙锁韧带和喙肩韧带,以获得理想的患者预后。本技术说明的目的是描述我们处理肩锁关节稳定术失败的技术,采用胫骨前肌和半腱肌异体移植物进行喙锁韧带和肩锁关节囊重建。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94b9/7953164/67f44e0efd31/gr1.jpg

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