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采用自制导板下钛缆置入治疗急性高位肩锁关节脱位。

Acute high-grade acromioclavicular joint dislocation patients treated with titanium cable insertion under a homemade guider.

机构信息

Department of Orthopedic, Xiaoshan First People's Hospital, Xiaoshan Affiliated Hospital of Wenzhou Medical University, No. 199 Shixin Road, Hangzhou, 311200, Zhejiang Province, China.

出版信息

J Orthop Surg Res. 2021 Apr 30;16(1):287. doi: 10.1186/s13018-021-02442-1.

Abstract

BACKGROUNDS

To describe a new technique for implanting a double-bundle titanium cable to treat acromioclavicular (AC) joint dislocation via the new guider, and evaluate clinic outcomes.

METHODS

A retrospective study of patients treated for acute high-grade acromioclavicular joint dislocation from June 2016 to January 2020 in our trauma center, twenty patients with AC joint dislocation were managed with double-bundle titanium cable. It includes the following steps: (1) Put the guider under the coracoid close to the cortical; (2) drill proximal clavicle; (3) place the titanium cable; (4) perforate distal clavicle, (5) reset the acromioclavicular joint and lock titanium cable; and (6) suture the acromioclavicular ligament. An independent reviewer conducted functional testing of these patients, including the use of coracoclavicular distance (CCD), visual analog scale (VAS) scores, and Constant-Murley scores (CMS).

RESULTS

All patients are presented following at a median duration of 15 months (12-24months) after the surgery. All patients based on X-ray evaluation and clinic evaluation. The median CCD was 7.5 (6-14) mm, the VAS score was 0.55 (0-2), the CMS score was 95.5 (92-99). One patient had subluxation again at the final follow-up based on X-ray examination.

CONCLUSIONS

This study demonstrates that the AC joint fixation anatomically with double-bundle titanium, acquired excellent outcomes in terms of the recovery of shoulder joint function and radiographic outcomes. It has a low complication rate and need not remove the hardware.

摘要

背景

描述一种通过新导板植入双束钛缆治疗肩锁关节(AC)脱位的新技术,并评估临床结果。

方法

回顾性分析 2016 年 6 月至 2020 年 1 月在我院创伤中心治疗的急性高分级肩锁关节脱位患者,20 例 AC 关节脱位患者采用双束钛缆治疗。包括以下步骤:(1)将导板置于喙突下靠近皮质;(2)钻近锁骨;(3)放置钛缆;(4)刺穿远锁骨;(5)复位肩锁关节并锁定钛缆;(6)缝合肩锁韧带。一位独立的评估者对这些患者进行了功能测试,包括使用喙锁距离(CCD)、视觉模拟评分(VAS)和 Constant-Murley 评分(CMS)。

结果

所有患者均在术后中位数 15 个月(12-24 个月)时进行随访。所有患者均行 X 线评估和临床评估。中位数 CCD 为 7.5(6-14)mm,VAS 评分为 0.55(0-2),CMS 评分为 95.5(92-99)。根据 X 线检查,1 例患者在末次随访时再次出现半脱位。

结论

本研究表明,AC 关节采用双束钛缆固定解剖学上具有良好的效果,在肩关节功能和影像学结果的恢复方面取得了良好的效果。并发症发生率低,无需取出内固定物。

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