Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, 271, Cheonbo-ro, Uijeongbu, Gyeonggi-do, 11765, Republic of Korea.
BMC Musculoskelet Disord. 2022 Jul 6;23(1):648. doi: 10.1186/s12891-022-05589-y.
Acromioclavicular (AC) joint dislocation is common among shoulder injuries, and various surgical methods have been introduced for effective ligament reconstruction. Reconstruction of the coracoclavicular (CC) ligament in the anatomical position using autologous tendons is a recent surgical trend. This study is to report clinical and radiologic results of reconstruction of the CC ligament using an autologous palmaris longus tendon interweaved with Mersilene tape (PLMT) with a minimum 2-year follow-up.
This retrospective study analyzed 76 patients (mean age, 43.4 ± 11.2 years) with AC joint dislocation treated by reconstruction of the CC ligament with PLMT, from March 2004 to February 2017. The mean follow-up period was 28 ± 6.7 months (range, 24-66 months). The Visual Analog Scale (VAS) for pain assessment, American Shoulder and Elbow Surgeons rating scale (ASES), and Constant Score (CS) were used to evaluate clinical outcomes at the preoperative and the final follow-ups. CC and AC distances were measured using anteroposterior (AP) X-ray preoperatively and at the final follow-up for radiologic outcomes. Complications were also assessed.
The mean preoperative VAS for pain, ASES, CS were 5.7 ± 0.7, 77.1 ± 6.2, and 61.5 ± 5.2, respectively. These scores at the final follow-up improved to 2.1 ± 0.5, 90.9 ± 4.3, and 94 ± 7.0, respectively (p = 0.043, p < 0.001, p < 0.001). The mean preoperative CC and AC distances were 16.49 ± 3.73 mm and 13.84 ± 3.98 mm, respectively. The final follow-up CC and AC distances were 9.29 ± 2.72 mm and 5.30 ± 2.09 mm, respectively (p < 0.001, p < 0.001). Although a slight re-widening of the CC distance occurred in 10 patients (13.1%), most patients regained full range of motion of the affected shoulder at the final follow-up.
The CC ligament reconstruction with PLMT for the treatment of AC joint dislocation showed good clinical and radiological results. This technique could be a good alternative treatment for AC dislocations.
肩伤中常见肩锁关节（AC）脱位，各种手术方法已被引入以进行有效的韧带重建。使用自体肌腱在解剖位置重建喙锁（CC）韧带是最近的手术趋势。本研究报告了使用自体掌长肌腱与 Mersilene 带交织（PLMT）重建 CC 韧带的临床和影像学结果，随访时间至少为 2 年。
本回顾性研究分析了 2004 年 3 月至 2017 年 2 月期间采用 PLMT 重建 CC 韧带治疗的 76 例（平均年龄 43.4±11.2 岁）肩锁关节脱位患者。平均随访时间为 28±6.7 个月（范围 24-66 个月）。术前和末次随访时使用视觉模拟评分（VAS）评估疼痛、美国肩肘外科医生评分（ASES）和常数评分（CS）进行临床评估。术前和末次随访时均行前后位（AP）X 线片测量 CC 和 AC 距离，以评估影像学结果。还评估了并发症。
术前 VAS 疼痛评分、ASES 和 CS 分别为 5.7±0.7、77.1±6.2 和 61.5±5.2。末次随访时分别改善至 2.1±0.5、90.9±4.3 和 94±7.0（p=0.043、p<0.001、p<0.001）。术前 CC 和 AC 距离分别为 16.49±3.73mm 和 13.84±3.98mm。末次随访时 CC 和 AC 距离分别为 9.29±2.72mm 和 5.30±2.09mm（p<0.001、p<0.001）。虽然 10 名患者（13.1%）出现 CC 距离轻微再增宽，但大多数患者在末次随访时恢复了受累肩关节的全范围活动度。
PLMT 重建 CC 韧带治疗肩锁关节脱位的临床和影像学结果良好。该技术可能是治疗 AC 脱位的一种较好的替代方法。
