Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong Province, China.
Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
BMC Musculoskelet Disord. 2022 Jan 3;23(1):15. doi: 10.1186/s12891-021-04915-0.
Double-endobutton technique, as a widely accepted strategy for the treatment of acromioclavicular joint dislocation, is undergoing constant improvement. This study aims to assess the clinical effect of a modified single-endobutton combined with the nice knot in the fixation of Rockwood type III or V acromioclavicular joint dislocation.
From January 2016 to June 2019, 16 adult patients (13 males and 3 females) with Rockwood type III or V acromioclavicular joint dislocation were treated with a modified single-endobutton technique combined with the nice knot in our department. The age ranged from 18 to 64 years old with an average of 32.8 years old. Operative time, intraoperative blood loss, post-operative clinical outcomes and radiographic results were recorded and analyzed. Preoperative and last follow-up scores in the Constant-Murley Scale, Neer score, Rating Scale of the American Shoulder and Elbow Surgeons and VAS scale and complications such as infection, re-dislocation, implant loosening, medical origin fracture and hardware pain were recorded and evaluated.
Sixteen patients were followed up for 6 to 18 months with an average of 10.3 months. The operative time was 50-90 min with an average of (62.5 ± 3.10) min. The intraoperative blood loss was 30-100 ml, with an average of (55.0 ± 4.28) ml. The complications, such as wound infection, internal fixation failure and fractures, were not found in these cases. According to Karlsson criteria, there were excellent in 14 cases, good in 2 cases at the final follow-up. The mean VAS score of the patients was 5.88 ± 0.26 preoperatively, compared with 0.19 ± 0.14 at the final follow-up evaluation. The difference was statistically significant (P < 0.05). The mean Constant score was 45.5 ± 2.0 preoperatively, compared to 94.0 ± 0.73 at the final follow-up evaluation. The difference was statistically significant (P < 0.05). Patients had statistically significant preoperative and postoperative AC (acromioclavicular distance) and CC (coracoclavicular distance) distances (P < 0.05); 6 months postoperatively the AC(P = 0.412) and CC(P = 0.324) distances were not statistically significant compared to the healthy side.
Nice knot provides a reliable fixation for the single-endobutton technique in the treatment of acromioclavicular dislocations. The modified single-endobutton technique combined with the nice knot can achieve good clinical outcomes in the treatment of Rockwood type III or V acromioclavicular joint dislocation.
双 Endobutton 技术作为治疗肩锁关节脱位的一种广泛接受的策略，正在不断改进。本研究旨在评估改良单 Endobutton 技术结合 Nice 结固定 Rockwood Ⅲ或Ⅴ型肩锁关节脱位的临床效果。
2016 年 1 月至 2019 年 6 月，我科采用改良单 Endobutton 技术结合 Nice 结治疗 Rockwood Ⅲ或Ⅴ型肩锁关节脱位患者 16 例，其中男 13 例，女 3 例，年龄 18～64 岁，平均 32.8 岁。记录并分析手术时间、术中出血量、术后临床疗效和影像学结果。记录并评估术前和末次随访时 Constant-Murley 评分、Neer 评分、美国肩肘外科医师评分和视觉模拟评分（VAS）以及感染、再脱位、内固定松动、医源性骨折和内固定物疼痛等并发症。
16 例患者获得 6～18 个月（平均 10.3 个月）随访，手术时间 50～90 min，平均（62.5±3.10）min；术中出血量 30～100 ml，平均（55.0±4.28）ml。无切口感染、内固定失败及骨折等并发症发生。末次随访根据 Karlsson 标准评定疗效：优 14 例，良 2 例。患者术前 VAS 评分为 5.88±0.26，末次随访时为 0.19±0.14，差异有统计学意义（P<0.05）。术前 Constant 评分为 45.5±2.0，末次随访时为 94.0±0.73，差异有统计学意义（P<0.05）。患者术前和末次随访时肩锁关节间距（AC）和喙锁关节间距（CC）比较差异均有统计学意义（P<0.05）；术后 6 个月时，AC（P=0.412）和 CC（P=0.324）与健侧比较差异无统计学意义。
Nice 结为单 Endobutton 技术治疗肩锁关节脱位提供了可靠的固定，改良单 Endobutton 技术结合 Nice 结治疗 Rockwood Ⅲ或Ⅴ型肩锁关节脱位可获得良好的临床效果。
