Han Xiao-Dong, Deng Bin, Meng Xiang-Bo, Ji Xian-Zhong, Meng Xian-Qing
Department of Orthopaedics, Zoucheng People's Hospital, Zoucheng 273500, Shandong, China.
Zhongguo Gu Shang. 2021 Dec 25;34(12):1152-7. doi: 10.12200/j.issn.1003-0034.2021.12.012.
To study the clinical efficacy and complications of Endobutton titanium plate and clavicle hook plate in the treatment of acromioclavicular dislocation.
Total 48 patients with Rockwood Ⅲ to Ⅴ acromioclavicular joint dislocation from March 2015 to May 2019 were retrospectively divided into two groups according to different surgical methods. Among the patients, 23 patients were treated with Endobutton loop titanium plate fixation (observation group), including 15 males and 8 females, ranging in age from 23 to 59 years old, with an average of(36.2±8.1) years old;Rockwood type Ⅲ in 6 cases, type Ⅳ in 11 cases and type Ⅴ in 6 cases. Twenty-five patients were treated with clavicular hook plate(control group), including 17 males and 8 females, ranging in age from 22 to 54 years old, with an average of (34.7±6.4) years old; Rockwood type Ⅲ in 6 cases, type Ⅳ in 14 cases and type Ⅴ in 5 cases. The operation time, intraoperative bleeding, hospitalization time, visual analogue scale (VAS) of pain, Constant-Murley score of shoulder function and postoperative complications were compared between the two groups.
All the patients were followed up, and the duration ranged from 24 to 51 months, with a mean of (30.5±6.5) months. The amountof bleeding and hospitalization time in the observation group were (71.9±4.0) ml and(8.2±1.6) d respectively;and those in the control group were (97.6±13.4) ml and (12.8±1.2) d respectively. There was significant difference between the two groups (<0.05). There was no significant difference in operation time between the two groups(>0.05). The VAS scores of the observation group immediately after operation and 12 months after operation were 4.00±0.39 and 1.58±0.13 respectively, which were statistically significant compared with 7.32±0.43 and 3.09±0.23 in the control group (<0.05). The Constant-Murley scores of shoulder function in the observation group were 59.65±0.15 and 85.97 ±0.73 immediately and 12 months after operation, which were significantly different from those in the control group 52.77±0.19 and 55.78±0.19(<0.05). In the observation group, there were 1 case of shoulder pain and 1 case of ectopic ossification; in the control group, there were 1 case of internal fixation failure, 3 cases of acromion impact, 3 cases of shoulder pain and 3 cases of ectopic ossification. There was significant difference between the two groups (<0.05).
Compared with clavicular hook plate internal fixation in the treatment of acromioclavicular joint dislocation, Endobutton loop titanium plate internal fixation technology has the advantages of less surgical bleeding, shorter hospitalization time, less postoperative pain, good recovery of shoulder joint function and less complications.
探讨Endobutton钛板与锁骨钩钢板治疗肩锁关节脱位的临床疗效及并发症。
回顾性分析2015年3月至2019年5月收治的48例RockwoodⅢⅤ型肩锁关节脱位患者,根据不同手术方式分为两组。其中,采用Endobutton袢钛板固定治疗23例(观察组),男15例,女8例;年龄2359岁,平均(36.2±8.1)岁;RockwoodⅢ型6例,Ⅳ型11例,Ⅴ型6例。采用锁骨钩钢板治疗25例(对照组),男17例,女8例;年龄22~54岁,平均(34.7±6.4)岁;RockwoodⅢ型6例,Ⅳ型14例,Ⅴ型5例。比较两组手术时间、术中出血量、住院时间、视觉模拟评分法(VAS)疼痛评分、肩关节功能Constant-Murley评分及术后并发症。
所有患者均获随访,随访时间24~51个月,平均(30.5±6.5)个月。观察组术中出血量和住院时间分别为(71.9±4.0)ml、(8.2±1.6)d,对照组分别为(97.6±13.4)ml、(12.8±1.2)d,两组比较差异有统计学意义(<0.05)。两组手术时间比较差异无统计学意义(>0.05)。观察组术后即刻及术后12个月VAS评分分别为4.00±0.39、1.58±0.13,与对照组术后即刻及术后12个月的7.32±0.43、3.09±0.23比较,差异有统计学意义(<0.05)。观察组术后即刻及术后12个月肩关节功能Constant-Murley评分分别为59.65±0.15、85.97±0.73,与对照组的52.77±0.19、55.78±0.19比较,差异有统计学意义(<0.05)。观察组发生肩关节疼痛1例、异位骨化1例;对照组发生内固定失败1例、肩峰撞击3例、肩关节疼痛3例、异位骨化3例。两组比较差异有统计学意义(<0.05)。
与锁骨钩钢板内固定治疗肩锁关节脱位相比,Endobutton袢钛板内固定技术具有手术出血少、住院时间短、术后疼痛轻、肩关节功能恢复好及并发症少等优点。